Filipovich et al developed criteria for the severity of chronic graft-versus-host disease (GVHD) for the National Institutes of Health. One of the criteria involved ocular involvement.
Patient selection: chronic GVHD
Parameters:
(1) dry eye symptoms
(2) number of times eye drops used per day
(3) interference with activities of daily living (ADL)
(4) keratoconjunctivitis sicca
|
Parameter |
Finding |
Points |
|
dry eye symptoms |
none |
0 |
|
|
mild |
1 |
|
|
moderate |
2 |
|
|
severe |
3 |
|
number of times eye drops used per day |
none |
0 |
|
|
<= 3 times per day |
1 |
|
|
> 3 times per day |
2 |
|
interference with ADL |
none |
0 |
|
|
some |
2 |
|
|
significant or unable to work |
3 |
|
keratoconjunctivitis sicca |
absent |
0 |
|
|
signs but asymptomatic |
1 |
|
|
symptomatic but no loss of vision |
2 |
|
|
loss of vision |
3 |
where:
• For keratoconjunctivitis sicca the Grade 2 status was not part of original table but seemed appropriate.
grade for ocular involvement =
= GRADE(max grade for the 4 parameters)
The tear test is an objective measure of tear production (normal > 10 mm) but the results were not used in grading.
Specialty: Immunology/Rheumatology
