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Among these target organs, ocular involvement occurs in ~60% of GVHD patients (1,3,4), and affects almost all parts of the eye, particularly cornea, conjunctiva, lids and lacrimal gland, resulting in a wide spectrum of ocular complications (1,2,5-8). Although ocular involvement is generally not a fatal problem, it has been well recognized that ocular GVHD causes considerable suffering and significantly impairs the quality of life (1-4,6-9). The frequent and potentially severe ocular involvement in GVHD patients necessitates Selleck KPT-330 a full ocular evaluation (pre- and post-transplantation) of these patients for early recognition and timely treatment prior to the onset of other complications. Currently, the diagnosis of ocular GVHD is mainly based on the presence of ocular manifestations such as new-onset dry, gritty, or painful eyes, keratoconjunctivitis sicca, photophobia and punctate keratopathy, and is commonly confirmed by invasive biopsy or other relevant tests (5). Whereas, such clinical manifestations usually occur in a late phase of ocular GVHD and the recognition is more or less a subjective procedure. On the other hand, the invasive nature of biopsy precludes its use in the longitudinal assessment of disease progression and treatment response. Thus, a non-invasive examining method capable of detecting early changes is particularly Fossariinae attractive in the ocular GVHD. In addition, a practical treatment guideline is necessary for diagnosing and treating ocular GVHD. Due to the frequent involvement of conjunctiva in the ocular GVHD, Jabs and his colleagues proposed a conjunctival GVHD staging system (8) and then refined with additional examination experience (4). This staging system mainly outlines the development of conjunctival GVHD. However, the involvement of other ocular GVHD manifestations is not considered. This is largely due to the current lack of appropriate assessment tools. Optical coherence tomography (OCT) is an imaging tool capable of providing micrometer-resolution (Rho signaling pathway inhibitor volumetric imaging of biological tissue in a non-contact, non-invasive and real-time fashion (10-12). Based on these attributes, OCT is considered particularly suited for ocular imaging and is currently part of the clinical standard of patient care in ophthalmology. The aim of this pilot case study is to explore the feasibility of using OCT to better evaluate ocular GVHD. Based on the common manifestations of ocular GVHD, the OCT imaging is mainly focused on four regions of interests (ROIs), including conjunctiva, cornea, eyelids and tear meniscus. Materials and methods The study was approved by the Institutional Review Board at the Fred Hutchinson Cancer Research Center and the University of Washington. The patient was recruited with prior informed consent.