儿童眼移植物抗宿主病诊治进展

Diagnosis and treatment progress on pediatric ocular graft-versus-host disease

  • 摘要: 眼移植物抗宿主病是造血干细胞移植术后的常见并发症之一,主要临床表现为干眼,病情进展可出现角膜溃疡穿孔、眼表衰竭等严重并发症,影响患者视力和生活质量。目前,国际上已有较多关于成人眼移植物抗宿主病的研究及临床规范,但关于儿童眼移植物抗宿主病的研究尚未受到足够关注,缺乏相关的基础数据和诊断标准。儿童对眼部症状表述能力有限、临床检查欠合作,眼科医师对该病认识不足,导致该病易被漏诊误诊。因此,本文从发病机制、发生率、危险因素、临床表现、诊断和治疗对儿童眼移植物抗宿主病的研究进展进行综述,以期为未来加强儿童此疾病的临床研究、拓展基础研究等提供思路。

     

    Abstract: Ocular graft-versus-host disease is one of the common complications after hematopoietic stem cell transplantation. Dry eye is the main clinical manifestation. Severe complications, such as corneal ulcer perforation and ocular surface failure may occur along with the progression of ocular graft-versus-host disease, which affects the visual acuity and quality of life of the patients. At present, multiple international researches and clinical guidelines for adult ocular graft-versus-host disease have been available. Nevertheless, pediatric ocular graft-versus-host disease has captivated insufficient attention, and relevant basic data and diagnostic criteria are still lacking. Children possess limited capability to express ocular symptoms, and lack of cooperation in clinical examination. In addition, ophthalmologists have insufficient understanding of this disease, which collectively increase the risk of missing diagnosis and misdiagnosis. In this article, the research progress on the pathogenesis, incidence, risk factors, clinical manifestations, diagnosis and treatment of pediatric ocular graft-versus-host disease was reviewed, aiming to provide ideas for strengthening clinical trials and expanding basic research of this disease in children.

     

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