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PROSE Treatment in Ocular Graft Versus Host Disease; A Five Year Follow-up
Methods: All oGVHD patients seen in consultation for PROSE treatment from 1/1/2008 – 6/30/2008 were identified through billing records. Retrospective review of medical records, manufacturing data, and 5 year quality data was undertaken.
Results: This 2008 oGVHD cohort was comprised of 21 patients. As of July 2013, the conclusion of the follow-up period, 6 patients were deceased and excluded from subsequent analysis. One patient was not a candidate for PROSE treatment due to not completing the training process, leaving 14 patients who were dispensed devices. After five years, continued device wear was confirmed in 10 of these 14 (71%) patients. Discontinuation of wear was confirmed in 3/14 (21%) patients. We could not ascertain wearing statusin the remaining 1 (7%) patients. Likelihood of continued device wear at five years is not dependent on age, sex, general health status or proximity of residence to our clinic (p>0.05, for each mean, by unpaired t-test). Reasons for discontinuation of wear are reported. NEI VFQ-25 composite score increased for patients wearing PROSE devices at 6 months (D=+26 points, p<0.001, mean=85) with no significant decline after five years (D =-3 points, p=0.73).
Conclusions: PROSE treatment offers continued benefit, as defined by continued device wear and visual functioning at 5 years, to the majority of oGVHD candidates who were dispensed devices. PROSE treatment is characterized by long-term success in the management of Ocular Graft Versus Host Disease.