Insight, The Journal of ASORN ASORN Insight 2018 Q3 - Page 19

FOCUS TABLE 1 Ophthalmic Follow-up Recommendations for Allogeneic HSCT Patients Intervention Visual acuity testing Dry eye / ocular surface assessment Slit-lamp ocular fundus exami- nation Evaluation of ocular clinical symptoms Evaluating for GVHD, medication toxicities DES, keratoconjunctivitis sicca, ocular GVHD Cataracts, retinal microvasculopathy DES, GVHD, medication toxicities Recommended time interval Pre-HSCT Pre-HSCT (Giannaccare et al., 2017) 1 year post-HSCT (Fred Hutchinson Cancer Research Center, 2017; Majhail et al., 2012) At each visit and as needed 6 months post-HSCT (Clark, Savani, Mohty & Savani, 2016; Majhail et al., 2012) 1 year post-HSCT (Clark, Savani, Mohty & Savani, 2016; Majhail et al., 2012) 6 months post-HSCT 1 year post-HSCT and as needed Annually thereafter (Fred Hutchinson Cancer Research Center, 2017) Annually thereafter (Clark, Savani, Mohty & Savani, 2016; Majhail et al., 2012) and as needed Note: GHVD = graft-vs.-host disease; DES = ‘É䁕唁Í幑ɽµ”¸‘…Áѕ™É½´ƒŠq]¡…Ё¼]”9••Ñ¼-¹½Ü‰½ÕЁ±±½•¹•¥Œ!•µ…ѽÁ½¥•Ñ¥ŒMѕ´ •±°QɅ¹ÍÁ±…¹ÐMÕÉ٥ٽÉÌÿŠt‰ä ¸ ±…ɬ°)4¸M…Ù…¹¤°4¸5½¡Ñ䰁…¹¸M…Ù…¹¤°€ÈÀÄØ° ½¹”5…Éɽ܁QɅ¹ÍÁ±…¹Ñ…Ñ¥½¸°€ÔĠर€ÄÀÈ׊LÄÀÌÄì1½¹œµÑ•É´™½±±½ÜµÕÀ…™Ñ•È¡•µ…ѽÁ½¥•Ñ¥ŒÍѕ´•±°ÑɅ¹ÍÁ±…¹Ð聕¹•É…°Õ¥‘•±¥¹•Ì™½ÈÉ•™•ÉÉ¥¹œ)Á¡åÍ¥¥…¹Ì°ɕ!Õэ¡¥¹Í½¸ …¹•ÈI•Í•…ɍ  •¹Ñ•È°€ÈÀÄÜ°É•ÑÉ¥•Ù•™É½´¡ÑÑÁÌè¼½ÝÝܹ™É•‘¡Õэ ¹½Éœ½½¹Ñ•¹Ð½‘…´½ÁՉ±¥Œ½Qɕ…ѵ•¹ÐµMÕÁ½Éн1½¹œµQ•É´µ½±±½ÜµUÀ½1QU}!M Q}Õ¥‘•±¥¹•Í|)Á¡åÍ¥¥…¹Ì¹Á‘˜ìƒŠqI•½µµ•¹‘•MÉ••¹¥¹œ…¹Aɕٕ¹Ñ¥Ù”AɅÑ¥•Ì™½È1½¹œµÑ•É´MÕÉ٥ٽÉ́™Ñ•È!•µ…ѽÁ½¥•Ñ¥Œ •±°QɅ¹ÍÁ±…¹Ñ…Ñ¥½¸³Št‰ä8¸5…©¡…¥°°(¸I¥éé¼°L¸1•”°4¸±©Õɘ°d¸ÑÍÕф° ¸) ½¹™¥´°ƒŠ˜¸Q¥¡•±±¤°€ÈÀÄÈ° ½¹”5…Éɽ܁QɅ¹ÍÁ±…¹Ñ…Ñ¥½¸°€Ðܠ̤°€ÌÌߊLÌÐÄ쁅¹ƒŠq=Õ±…ȁMÕə…”¹…±åͥ́¥¸!•µ…ѽ±½¥…°A…Ñ¥•¹Ñ́ •™½É”…¹™Ñ•È±±½•¹•¥Œ!•µ…ѽÁ½¥•Ñ¥ŒMѕ´ •±°)QɅ¹ÍÁ±…¹Ñ…Ñ¥½¸è%µÁ±¥…Ñ¥½¸™½È…¥±ä ±¥¹¥…°AɅÑ¥”³Št‰ä¸¥…¹¹……É”°¸ ½¹¥™…餰4¸M•Í̈́°¸…¸°4¸ÉÁ¥¹…Ѥ°4¸°4¸ɕͥ¹„°€¸¸¸»  ¸ …µÁ½Ì°€ÈÀÄÜ°唰€ÌÄ ÄÀ¤°€ÄÐÄߊLÄÐÈظ)±•¹Í•Ì…¹Ñ¡”ÁɽÍÑ¡•Ñ¥ŒÉ•Á±…•µ•¹Ð½˜Ñ¡”½Õ±…ȁÍÕə…”•¼´ƒŠˆ€Q¡”ÑåÁ”½˜‘½¹½È€¡Ý¡•Ñ¡•ÈÉ•±…Ñ•½ÈÕ¹É•±…Ñ•¤…¹Ñ¡”Ñ¥Ì´)ÍåÍѕ´€¡AI=M¤‘•Ù¥”€¡ ½Íѽ¹M¥¡Ð¤¡…Ù”Í¡½Ý¸É•…Ё•™™•Œ´ÍՔ…¹Ñ¥•¸µ…э ÍхÑÕÌ聽¹½È•±±ÌÑ¡…Ё…É”µ½É”±½Í•±ä)ѥٕ¹•Í́¥¸Ñɕ…ѵ•¹Ð½˜Í•Ù•É”…͕́½˜‘É䁕唁‘Õ”Ñ¼½Õ±…ȁµ…э¡•Ñ¼Ñ¡”Á…Ñ¥•¹ÓŠé½Ý¸Ñ¥ÍÍՔÑåÁ”…ÉÉ䁱•Í́ɥͬ½˜½´´)Y!€¡I¥‘•Ì°É…¹…а!…э °€˜)…½‰Ì°€ÈÀÄÐì5…É¼•Ð…°¸°Á±¥…Ñ¥½¹ÌÑ¡…¸¥¹½µÁ±•Ñ•±ä½ÈÁ…ÉÑ¥…±±äµ…э¡••±±Ì¸(ÈÀÄܤ¸]¥Ñ Ñ¡”ÁՉ±¥…Ñ¥½¸½˜Ñ¡”Éä唁]½É­Í¡½ÀÉ¥Ñ•É¥„¥¸(ÈÀÄÜ°Ñ¡”½Á¡Ñ¡…±µ¥Œ¹ÕÉ͔…¸…¹Ñ¥¥Á…Ñ”„µ½É”Áɽѽ½°µ‰…Í•)…ÁÁɽ… Ñ¼‘É䁕唁µ…¹…•µ•¹Ð¥¸Ñ¡¥ÌÁ…Ñ¥•¹ÐÁ½ÁÕ±…Ñ¥½¸(¡)½¹•Ì•Ð…°¸°€ÈÀÄܤ¸QɅ¹ÍÁ±…¹Ð•¹Ñ•É́مÉ䁥¸Ñ¡•¥ÈÉ•½µµ•¸´)‘…Ñ¥½¹Ì™½ÈÁ½ÍеÑɅ¹ÍÁ±…¹Ð½Á¡Ñ¡…±µ¥Œ•Ù…±Õ…Ñ¥½¸¸ÍÕµµ…É䁽˜)ÁՉ±¥Í¡•É•½µµ•¹‘…Ñ¥½¹Ì…¸‰”™½Õ¹¥¸Q…‰±”€Ä¸+Šˆ€…ǻͥ¹”ÑɅ¹ÍÁ±…¹Ñ…Ñ¥½¸èQ¡”Á½ÍеÑɅ¹ÍÁ±…¹ÐÁ•É¥½¡…Ì)ÑɅ‘¥Ñ¥½¹…±±ä‰••¸‘¥Ù¥‘•¥¹Ñ¼•…ɱ䁅¹±…Ñ”Á¡…Í•Ì°Ý¥Ñ )Á…Ñ¥•¹Ñ́•¹•É…±±ä…ЁÉ•…ѕȁɥͬ½˜½µÁ±¥…Ñ¥½¹Ì‘ÕÉ¥¹œÑ¡”)™¥ÉÍЀÄÀÀ‘…ǻ…́ѡ”¥µµÕ¹”ÍåÍѕ´¥ÌÍÑ¥±°¥¸Ñ¡”•…ɱäÍх•Ì½˜)ɕ½Ù•Éä¸+Šˆ€AɕÁ…ɅѽÉ䀣Šq½¹‘¥Ñ¥½¹¥¹ŸŠt¤É•¥µ•¸ÑåÁ”聍¡•µ½Ñ¡•É…Á䁅¹¼)%µÁ±¥…Ñ¥½¹Ì™½È9ÕÉÍ¥¹œAɅÑ¥”…¹Ñ¡”)=Á¡Ñ¡…±µ¥ŒQ•…´)=Á¡Ñ¡…±µ¥Œ¹ÕÉ͕́¡…Ù”µ…¹ä½ÁÁ½ÉÑÕ¹¥Ñ¥•ÌÑ¼µ…­”Ù…±Õ…‰±”)½¹ÑÉ¥‰ÕÑ¥½¹Ì¥¸Ñ¡”…É”½˜Ñ¡•Í”½µÁ±¥…Ñ•Á…Ñ¥•¹ÑÌ°‰•¥¸´)¹¥¹œÝ¥Ñ ½‰Ñ…¥¹¥¹œ„½µÁ±•Ñ”¡¥ÍѽÉ䁙½ÕÍ¥¹œ½¸Ù¥Í¥½¸…¹)µ•‘¥…°½¹‘¥Ñ¥½¹Ì¸Ñ¡½É½Õ µ•‘¥…°¡¥ÍѽÉ䁽˜Ñ¡”ÑɅ¹ÍÁ±…¹Ð)Á…Ñ¥•¹Ð¥¹±Õ‘•Ìè+Šˆ€½Õµ•¹Ñ…Ñ¥½¸½˜Ñ¡”‘¥Í•…Í”¹••Íͥхѥ¹œÑɅ¹ÍÁ±…¹Ñ…Ñ¥½¸+Šˆ€Q¡”ÑåÁ”½ÈÑɅ¹ÍÁ±…¹Ð€¡…Õѽ±½½Ṍ½È…±±½•¹•¥Œ¤èÕѽ±½½ÕÌ)½ÈÉ…‘¥…Ñ¥½¸ì¡•µ½Ñ¡•É…Á•ÕÑ¥Œ…•¹Ð¡Ì¤Õ͕¸+Šˆ€MÑɕ¹Ñ ½˜½¹‘¥Ñ¥½¹¥¹œÉ•¥µ•¸è5啱½…‰±…Ñ¥Ù”½¹‘¥Ñ¥½¸´)¥¹œ…¥µÌÑ¼½µÁ±•Ñ•±ä‘•ÍÑɽäÑ¡”Á…Ñ¥•¹ÓŠé½Ý¸‰½¹”µ…ÉɽÜ)¥¸ÁɕÁ…É…Ñ¥½¸™½ÈÑɅ¹ÍÁ±…¹Ð¸I•‘Ս•µ¥¹Ñ•¹Í¥Ñ䁍½¹‘¥Ñ¥½¸´)¥¹œ€¡I% ¤°Õ͕™½ÈÁ…Ñ¥•¹Ñ́չ±¥­•±äÑ¼Ñ½±•É…Ñ”Ñ¡”•™™•Ñ́½˜)™Õ±°µÍÑɕ¹Ñ µå•±½…‰±…Ñ¥Ù”½¹‘¥Ñ¥½¹¥¹œ°…¥µÌÑ¼É•‘Ս”Ñ¡”)¹Õµ‰•È½˜Á…Ñ¥•¹ÓŠé½Ý¸‰½¹”µ…Éɽ܁•±±ÌÁÉ¥½ÈÑ¼ÑɅ¹ÍÁ±…¹Ð¸+Šˆ€ åѽµ•…±½Ù¥ÉÕ̀¡ 5X¤ÍхÑÕÌ聁Á…Ñ¥•¹ÐÁɕ٥½Õͱ䁥¹™•Ñ•)ݥѠ 5X…¸Õ¹‘•É¼É•…Ñ¥Ù…Ñ¥½¸½˜Ñ¡”Ù¥ÉṌ™½±±½Ü´)ÑɅ¹ÍÁ±…¹Ñ…Ñ¥½¸°¥¸Ý¡¥ Ñ¡”Á…Ñ¥•¹ÓŠé½Ý¸Íѕ´•±±Ì…É”¥¹œÑɅ¹ÍÁ±…¹Ð°Ý¥Ñ  5XÉ•Ñ¥¹¥Ñ¥Ì…́„Á½ÍÍ¥‰±”µ…¹¥™•Íф´)ɕµ½Ù•…¹Íѽɕ°Ñ¡•¸É•¥¹™Õ͕™½±±½Ý¥¹œ¡•µ½Ñ¡•É…Á䁽ȁѥ½¸¸ 5XÉ•Ñ¥¹¥Ñ¥Ì‰•¥¹ÌÝ¥Ñ ‰±ÕÉɕÙ¥Í¥½¸Ý¡¥ °¥˜±•™Ð)Ʌ‘¥…Ñ¥½¸Ñ¡•É…Á䰁…ÉÉ¥•ÌÝ¥Ñ ¥Ð„±½Ý•È¥¹¥‘•¹”½˜½µÁ±¤´Õ¹Ñɕ…Ñ•°¡…́„¡¥ É¥Í¬½˜…‘Ù…¹¥¹œÑ¼Ñ½Ñ…°±½Í́½˜Ù¥Í¥½¸)…Ñ¥½¹Ì°¥¹±Õ‘¥¹œ½Á¡Ñ¡…±µ¥Œ½µÁ±¥…Ñ¥½¹Ì°Ñ¡…¸…±±½•¹•¥Œ€¡1©Õ¹µ…¸°!…­­¤°€˜ ½•­ °€ÈÀÄĤ¸Q¡•Í”Á…Ñ¥•¹Ñ́µÕÍЁ‰”)ÑɅ¹ÍÁ±…¹Ñ…Ñ¥½¸°¥¸Ý¡¥ Ñ¡”Á…Ñ¥•¹ÐÉ••¥Ù•ÌÍѕ´•±±Ì™É½´„µ½É”±½Í•±äµ½¹¥Ñ½É•™½ÈÙ¥ÍՅ°¡…¹•Ì¸)‘½¹½È¸)½¹Ñ¥¹Õ•½¸Ñ¡”¹•áЁÁ…”)M=I8%9M%!PMÕµµ•È€ÈÀÄà(Ä