Current and emerging strategies for ocular chronic graft-versus-host disease

Ocular graft-versus-host disease (GVHD) is a serious complication following hematopoietic cell transplantation (HCT). In mild cases, it can manifest as eye discomfort, while in severe cases, patients may suffer from vision loss.Ocular GVHD is often treated in a stepwise fashion, starting with artificial tears and immunosuppressive agents progressing to more aggressive interventions as needed.Topical therapy alone is often sufficient for patients with mild symptoms.If the ocular surface inflammation is still difficult to control, systemic immunosuppressive therapy is required.Patients with severe corneal disease should be considered for surgery, which often has a poor prognosis in the presence of ocular inflammation.With the deepening of the understanding of the pathogenesis of the disease, a variety of new therapies such as rebamipide, diquafosol, JAK/SYK inhibitors, tranilast, lifitegrast, heparin, siRNA therapy and stem cell therapy have been introduced into clinical research and application.This article reviews the current and emerging strategies for ocular GVHD to provide references for clinical practice and research.