PROSE Treatment for Ocular XXXX as a Clinical Network Expands.

@entity1 @entity2132
BACKGROUND: Keratoconjunctivitis sicca occurs in 40% to 90% of @entity1 with @entity2132 (cGVHD). Ocular symptoms can have profound effects in both the visual function and quality of life of @entity1 with GVHD. We report the impact of prosthetic replacement of the ocular surface ecosystem (PROSE) treatment in @entity1 with cGVHD as a clinical network expands. METHODS: We queried the BostonSight PROSE manufacturing database from January 2002 to December 2011. @entity1 treated for ocular cGVHD were reported by age, gender, year, and network site where the treatment was undertaken. The baseline and six-month follow-up scores of visual function using a standardized validated instrument, the National Eye Institute Visual Function Questionnaire (NEI VFQ-25), were evaluated for a period in 2006 and again in 2010 after network expansion had occurred. RESULTS: A total of 407 @entity1 with a male:female ratio of 226:181, mean age was 51 years with ocular cGVHD underwent PROSE treatment from January 2002 to December 2011. By 2011, 67% of all cases were treated at network clinics. Baseline characteristics of @entity1 treated throughout the network in 2010 were similar to that of 2006 and 2010 cohorts from the main center. There was a significant improvement of 41 points (P<0.001) in composite NEI VFQ score among @entity1 treated across the network in 2010, similar to the improvement of 30 points (P<0.001) seen among the @entity1 treated at the main center in 2010. There was a trend toward lower baseline self-reported general health status (SRGHS) and VFQ scores among @entity1 treated at network clinics, suggesting that expansion of the network allows treatment of sicker @entity1 (lower general health status) or those more severely affected by ocular cGVHD. CONCLUSIONS: PROSE treatment of ocular cGVHD has increased in the last decade with the establishment of BostonSight network clinics across the United States. @entity1 treated at network clinics showed similar levels of baseline visual function and SRGHS, and achieved a similar high level of improvement in visual function as those treated at the main center. @entity1 -reported measures of functional status are useful in evaluating treatment options for @entity1 with cGVHD. PROSE treatment has significant positive impact on the visual function of @entity1 with ocular cGVHD regardless of whether the @entity1 is treated at the main center or at a network site.
