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Optom Vis Sci. 2016 Nov;93(11):1444-1448.

PROSE Treatment in Atypical Ocular Graft-Versus-Host Disease.

Author information

1
*OD †BA ‡MD Department of Ophthalmology, Keck School of Medicine of University of Southern California, Los Angeles, California (GBC, CT); and Doheny Eye Institute, University of California Los Angeles, Los Angeles, California (JAI).

Abstract

PURPOSE:

To report a case of persistent epithelial defects in a patient with ocular chronic graft-versus-host disease that required coordinated modulation of systemic immunosuppressive treatment and overnight wear of Prosthetic Replacement of the Ocular Surface Ecosystem (BostonSight PROSE, Needham, MA) devices to achieve ocular surface healing.

CASE REPORT:

The case of a 38-year-old male patient who presented with a 2-year history of ocular chronic graft-versus-host disease, ocular burning, pain, light sensitivity, and a 3-week history of bilateral corneal epithelial defects is presented. Standard therapies and an initial PROSE treatment utilizing customized scleral lenses were unsuccessful in resolving his ocular complications. A second trial of PROSE treatment involving overnight wear of the devices in combination with increased systemic immunosuppressant therapy ultimately allowed ocular surface healing and improved his discomfort, vision, and quality of life.

CONCLUSIONS:

Sight-threatening complications of ocular chronic graft-versus-host disease often require a multidisciplinary approach. Persistent corneal epithelial defects may require increased systemic immunosuppression and extension of PROSE treatment to overnight wear.

PMID:
27741087
DOI:
10.1097/OPX.0000000000001003
[Indexed for MEDLINE]

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