Implementation of a Multidisciplinary Eye Clinic within a Cancer Center for Patients at Risk of Ocular Graft versus Host Disease

Objective: Ocular graft-versus-host disease (oGVHD) affects approximately 50% of patients undergoing hematopoietic stem cell transplantation (HSCT). Guidelines for monitoring patients for oGVHD development are not clearly established. An oGVHD clinic at the University of Maryland Greenebaum Comprehensive Cancer Center (UMGCCC) was established to evaluate HSCT patients at risk of developing oGVHD. The objective of this study was to examine whether an integrated eye clinic corresponded with lower odds of developing oGVHD within 2 years post-HSCT. Design: A single-center retrospective longitudinal cohort study. Participants: One hundred eighty-three patients post-HSCT were included and compared patients treated before (n = 107) and after (n = 76) the UMGCCC Clinic opening in 2021. Methods: Ocular graft-versus-host disease odds within 2 years post-HSCT were compared between pre-UMGCCC and post-UMGCCC groups using multivariate logistic regression. A secondary analysis evaluated ophthalmic treatments initiated at the first post-transplant visit and their associations with oGVHD incidence. Bayesian logistic regression estimated posterior probability. Main Outcome Measures: We assessed the odds of oGVHD 2 years post-HSCT in pre-UMGCCC and post-UMGCCC groups. Conclusions: The opening of the UMGCCC Eye Clinic was associated with a nonsignificant reduction in oGVHD odds, corneal, and conjunctival staining in patients 2 years after HSCT. Our results support the importance of integrated eye care in reducing morbidity in patients undergoing HSCT. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.