{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T04:32:24Z","timestamp":1792211544470,"version":"4.4.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T00:00:00Z","timestamp":1698364800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>To verify the International Chronic Ocular Graft-Versus-Host Disease (ICCGVHD) Group diagnostic criteria and establish an easy-to-use and reliable diagnosis model for quick identification of chronic oGVHD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study included 180 patients (355 eyes) who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) and visited the Peking University Third Hospital Cornea and Ocular Surface Disease Specialist Clinic from July 2020 to February 2021. The proportion of chronic oGVHD was 76.06% (279\/355).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five complaints, including eye dryness, photophobia, foreign body sensation, eye redness, and burning sensation; six ophthalmic examinations, including Ocular Surface Disease Index (OSDI) score, corneal fluorescein staining (CFS), tear break-up time (TBUT), Schirmer\u2019s test score without anesthesia, conjunctival score, tear meniscus height, and non-ocular GVHD-involved organs were significantly different between patients with chronic oGVHD and control group (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.05). Binary logistic regression (backward LR algorithm) selection demonstrated that three variables retained diagnostic significance for chronic oGVHD: CFS (OR\u2009=\u20092.71 (1.92\u20133.81), <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001), Schirmer\u2019s test score without anesthesia (OR\u2009=\u20090.83 (0.76\u20130.91), <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001), and conjunctival score (OR\u2009=\u20091.96 (1.13\u20133.42), <jats:italic>p<\/jats:italic>\u2009=\u20090.031). A nomogram for the identification of chronic oGVHD was developed, and its performance was examined using an internal validation cohort (118 eyes). The areas under the curve (AUCs) for the three-variable-based nomogram were 0.976 (95% CI (0.959\u20130.992), <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.01) and 0.945 (95% CI (0.904\u20130.986), <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.01) in the development and internal validation cohorts, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This concise three-variable-based nomogram based on ICCGVHD criteria could serve as an easy-to-use and reliable tool for rapid screening of chronic oGVHD.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2023.1277194","type":"journal-article","created":{"date-parts":[[2023,10,28]],"date-time":"2023-10-28T21:34:25Z","timestamp":1698528865000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Development and validation of a diagnostic model for the identification of chronic ocular graft-versus-host disease (oGVHD)"],"prefix":"10.3389","volume":"10","author":[{"given":"Zhan","family":"Shen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bohao","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liyuan","family":"Tao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiao","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongmei","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinghan","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Hong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,10,27]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1182\/blood-2018-01-791335","article-title":"Allogeneic hematopoietic stem cell transplantation for T-cell lymphomas","volume":"132","author":"Schmitz","year":"2018","journal-title":"Blood"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"4258","DOI":"10.1158\/1078-0432.CCR-22-0809","article-title":"Longitudinal outcome over two decades of unrelated allogeneic stem cell transplantation for relapsed\/refractory acute myeloid leukemia: an ALWP\/EBMT analysis","volume":"28","author":"Nagler","year":"2022","journal-title":"Clin Cancer Res"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"2167","DOI":"10.1056\/NEJMra1609337","article-title":"Acute graft-versus-host disease - biologic process, prevention, and therapy","volume":"377","author":"Zeiser","year":"2017","journal-title":"N Engl J Med"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1851","DOI":"10.1016\/j.bbmt.2019.05.016","article-title":"Resolved versus active chronic graft-versus-host disease: impact on post-transplantation quality of life","volume":"25","author":"Kurosawa","year":"2019","journal-title":"Biol Blood Marrow Transplant"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"3419","DOI":"10.1038\/srep03419","article-title":"International chronic ocular graft-vs-host-disease (GVHD) consensus group: proposed diagnostic criteria for chronic GVHD (part I)","volume":"3","author":"Ogawa","year":"2013","journal-title":"Sci Rep"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1341","DOI":"10.1007\/s00417-019-04301-6","article-title":"Ocular surface system alterations in ocular graft-versus-host disease: all the pieces of the complex puzzle","volume":"257","author":"Giannaccare","year":"2019","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2018\/6430953","article-title":"Manifestation of clinical categories of ocular graft-versus-host disease","volume":"2018","author":"Qiu","year":"2018","journal-title":"J Ophthalmol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"945","DOI":"10.1016\/j.bbmt.2005.09.004","article-title":"National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and staging working group report","volume":"11","author":"Filipovich","year":"2005","journal-title":"Biol Blood Marrow Transplant"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"780","DOI":"10.1016\/j.bbmt.2015.01.003","article-title":"National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: III. The biomarker working group report","volume":"21","author":"Paczesny","year":"2014","journal-title":"Biol Blood Marrow Transplant 2015"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1016\/j.jtos.2022.09.002","article-title":"Multicenter prospective validation study for international chronic ocular graft-versus-host disease consensus diagnostic criteria","volume":"26","author":"Ogawa","year":"2022","journal-title":"Ocul Surf"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1038\/s41433-018-0210-4","article-title":"Comparison among different diagnostic criteria for chronic ocular graft-versus-host disease applied with and without pre-transplant ophthalmological examination","volume":"33","author":"Giannaccare","year":"2019","journal-title":"Eye (Lond)"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"DES7","DOI":"10.1167\/iovs.17-23475","article-title":"Definition and diagnostic criteria of dry eye disease: historical overview and future directions","volume":"59","author":"Shimazaki","year":"2018","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1016\/j.jtos.2019.12.005","article-title":"Tear cytokine levels in the diagnosis and severity assessment of ocular chronic graft-versus-host disease(GVHD)","volume":"18","author":"Hu","year":"2020","journal-title":"Ocul Surf"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e033940","DOI":"10.1136\/bmjopen-2019-033940","article-title":"Reliability and validity of the Japanese version of the ocular surface disease index for dry eye disease","volume":"9","author":"Midorikawa-Inomata","year":"2019","journal-title":"BMJ Open"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2020\/3509064","article-title":"Objective imaging diagnostics for dry eye disease","volume":"2020","author":"Han","year":"2020","journal-title":"J Ophthalmol"},{"key":"ref16","first-page":"221","article-title":"Report of the National eye Institute\/industry workshop on clinical trials in dry eyes","volume":"21","author":"Lemp","year":"1995","journal-title":"CLAO J"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"273","DOI":"10.5301\/ejo.5000626","article-title":"The measurement of bulbar hyperemia: challenges and pitfalls","volume":"25","author":"Baudouin","year":"2015","journal-title":"Eur J Ophthalmol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1016\/j.bbmt.2014.12.001","article-title":"National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. The diagnosis and staging working group report","volume":"21","author":"Jagasia","year":"2014","journal-title":"Biol Blood Marrow Transplant 2015"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1016\/j.jtos.2017.05.008","article-title":"TFOS DEWS II definition and classification report","volume":"15","author":"Craig","year":"2017","journal-title":"Ocul Surf"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"2565","DOI":"10.1056\/NEJMra1703472","article-title":"Pathophysiology of chronic graft-versus-host disease and therapeutic targets","volume":"377","author":"Zeiser","year":"2017","journal-title":"N Engl J Med"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1550","DOI":"10.1016\/S0140-6736(09)60237-3","article-title":"Graft-versus-host disease","volume":"373","author":"Ferrara","year":"2009","journal-title":"Lancet"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"232.e1","DOI":"10.1016\/j.jtct.2020.12.018","article-title":"Tear lipid metabolites as potential diagnostic biomarkers for ocular chronic graft-versus-host disease","volume":"27","author":"Ma","year":"2021","journal-title":"Transplant Cell Ther"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1016\/j.bbmt.2016.09.023","article-title":"The biology of chronic graft-versus-host disease: a task force report from the National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease","volume":"23","author":"Cooke","year":"2017","journal-title":"Biol Blood Marrow Transplant"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"42195","DOI":"10.1038\/srep42195","article-title":"Heavy chain-hyaluronan\/pentraxin 3 from amniotic membrane suppresses inflammation and scarring in murine lacrimal gland and conjunctiva of chronic graft-versus-host disease","volume":"7","author":"Ogawa","year":"2017","journal-title":"Sci Rep"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"10720","DOI":"10.1038\/s41598-017-10237-w","article-title":"In vivo confocal microscopy evaluation of ocular surface with graft-versus-host disease-related dry eye disease","volume":"7","author":"He","year":"2017","journal-title":"Sci Rep"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1038\/s41409-018-0340-0","article-title":"Ocular graft-versus-host disease after hematopoietic cell transplantation: expert review from the late effects and quality of life working committee of the CIBMTR and transplant complications working party of the EBMT","volume":"54","author":"Inamoto","year":"2019","journal-title":"Bone Marrow Transplant"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1228","DOI":"10.3324\/haematol.2015.124131","article-title":"Predictive models for ocular chronic graft-versus-host disease diagnosis and disease activity in transplant clinical practice","volume":"100","author":"Curtis","year":"2015","journal-title":"Haematologica"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1016\/j.ophtha.2011.08.040","article-title":"Validation of measurement scales in ocular graft-versus-host disease","volume":"119","author":"Inamoto","year":"2012","journal-title":"Ophthalmology"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1038\/s41409-018-0090-z","article-title":"Ocular findings and ocular graft-versus-host disease after allogeneic stem cell transplantation without total body irradiation","volume":"53","author":"Pathak","year":"2018","journal-title":"Bone Marrow Transplant"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1097\/ICO.0000000000001109","article-title":"Validation of international chronic ocular graft-versus-host disease (GVHD) group diagnostic criteria as a chronic ocular GVHD-specific metric","volume":"36","author":"Rapoport","year":"2017","journal-title":"Cornea"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1097\/ICO.0000000000000340","article-title":"Onset of ocular graft-versus-host disease symptoms after allogeneic hematopoietic stem cell transplantation","volume":"34","author":"Shikari","year":"2015","journal-title":"Cornea"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1277194\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,28]],"date-time":"2023-10-28T21:34:28Z","timestamp":1698528868000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1277194\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,27]]},"references-count":31,"alternative-id":["10.3389\/fmed.2023.1277194"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2023.1277194","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,27]]},"article-number":"1277194"}}