Ocular surface characterization after allogeneic stem cell transplantation: A prospective study in a referral center

Abstract

Purpose: To characterize anatomical and functional changes in the ocular surface after hematopoietic stem cell transplantation. Methods: Three groups of patients were included in the study. Group 1: patients who had undergone allogeneic hematopoietic stem cell transplantation (HSCT) ( n = 26). Group 2: patients who developed chronic graft versus host disease (GvHD) after HSCT ( n = 14). Group 3: healthy subjects ( n = 20). A complete ophthalmological examination was undertaken in all subjects, including Schirmer's test, TBUT (break-up-time) test, Oxford scale, OSDI test, corneal tomography, and conjunctival CD8+ lymphocyte detection. Results: In Branch 1 (comparative analysis before and after HSCT in Group 1), statistically significant differences were found in the following variables: best-corrected visual acuity (BCVA) OD ( P = 0.08), OSDI test ( P = 0.003), TBUT OU (OD P = 0, OS P = 0.0003), Oxford test OU (OD P = 0.01, OS P = 0.0049), and CD8+ lymphocytes OU (OD P = 0.003, OS P = 0.01). In Branch 2 (comparative analysis between Group 2 and 3), the variables with statistically significant differences ( P < 0.001) in OU were: BCVA, OSDI test, Schirmer's test OU, TBUT test, Oxford test, and CD8+ lymphocytes. Finally, in Branch 3 (comparative analysis between Group 1 after HSCT and Group 2), statistically significant differences ( P < 0.001) were found OU: in OSDI test, Schirmer's test, and Oxford test OU; and with P < 0.005 in TBUT test OU. Conclusion: In our study, statistically significant changes were observed in the OSDI test, TBUT test, Oxford Scale, and the detection of CD8+ lymphocytes in patients who underwent HSCT. Differences were more significant in those patients who had developed GvHD after HSCT compared to those without GvHD.

Molecular Biomarkers in Ocular Graft-versus-Host Disease: A Systematic Review

“…Alba-Linero et al [20] Lipids: phosphatidylcholine, sphingomyelin, lactosylceramide, DHA No direct correlations were made between clinical parameters and potential biomarkers. The study focused on following changes in protein levels between both groups.…”

Augenbeteiligung bei Graft-versus-Host-Erkrankung

“…In gewissen Situationen kann auch eine Anfärbung mit anderen Vitalfarbstoffen wie Lissamingrün oder Bengalrosa sinnvoll sein. Für die qualitative Beurteilung des Tränenfilms ist die Messung der Tränenfilmaufrisszeit hilfreich [28]. Eine Messung der Tränenfilmosmolarität kann ebenfalls erwogen werden [29].…”

“…In certain situations, staining with other vital dyes such as lissamine green or rose bengal may also be useful. Measurement of the tear film breakup time is helpful for qualitative assessment of the tear film [28]. Measurement of tear film osmolarity may also be considered [29].…”

Comments on

“…We commend the authors' work in their study on ocular surface characterization after allogeneic hematopoietic stem cell transplant (allo-HSCT). [ 1 ] We wish to highlight a few points based on our experience. [ 2 3 4 ]…”

“…The authors[ 1 ] could have considered giving details of conditioning regimen and if this was the same for groups 1 and 2, as this can have implications in dry eye disease (DED). Addition of standard deviation and range to study parameters results and DED severity grades in oGvHD would have been helpful.…”