June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Behaviour of Conjunctival Goblet Cells after allogenic Hematopoietic Stem Cell Transplantation
Author Affiliations & Notes
  • Alexandra Knoll
    Interdisciplinary Uveitis Center, University Hospital Heidelberg, Heidelberg, Germany
  • Eva Jakob
    Interdisciplinary Uveitis Center, University Hospital Heidelberg, Heidelberg, Germany
  • Karin Brandauer
    Interdisciplinary Uveitis Center, University Hospital Heidelberg, Heidelberg, Germany
  • Bianca Dobner
    Interdisciplinary Uveitis Center, University Hospital Heidelberg, Heidelberg, Germany
  • Ute Hegenbart
    Heamatology, University Hospital Heidelberg, Heidelberg, Germany
  • Peter Dreger
    Heamatology, University Hospital Heidelberg, Heidelberg, Germany
  • Gerd Auffarth
    Ophthalmology, University Hospital Heidelberg, Heidelberg, Germany
  • Friederike Mackensen
    Interdisciplinary Uveitis Center, University Hospital Heidelberg, Heidelberg, Germany
  • Footnotes
    Commercial Relationships Alexandra Knoll, None; Eva Jakob, None; Karin Brandauer, None; Bianca Dobner, None; Ute Hegenbart, None; Peter Dreger, None; Gerd Auffarth, None; Friederike Mackensen, Abbott (F), Heidelberg Engineering (F), Heidelberg Engineering (R)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 5422. doi:
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      Alexandra Knoll, Eva Jakob, Karin Brandauer, Bianca Dobner, Ute Hegenbart, Peter Dreger, Gerd Auffarth, Friederike Mackensen; Behaviour of Conjunctival Goblet Cells after allogenic Hematopoietic Stem Cell Transplantation. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5422.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

The ocular Graft-versus-Host-Disease (oGvHD) is a frequent sequelae after hematopoietic stem cell transplantation (HSCT). We hypothesized that a decrease of goblet cells in the conjunctival epithelium can serve as predictive marker for an emerging oGvHD. To assess goblet cell density we compared the more invasive impression cytology (IC) with the less invasive in vivo confocal microscopy (IVCM) (Figure A,B).

 
Methods
 

Patients who were listed for HSCT were examined before and 100 days after the transplantation. The examination included a questionnaire, slit lamp examination, Schirmer Test II, impression cytology and confocal microscopy of the conjunctiva with the Heidelberg Retina Tomograph with the Rostock Cornea Modul attachment (HRT-RCM). At least three specimen/pictures of each patient were assessed for goblet cell density and means were calculated. The Approval of the Ethical Review Board Heidelberg and informed consent was obtained.

 
Results
 

44 patients were included (mean age 56 years). 18 patients were not re-examined after HSCT (4 died, 2 were pre final, 2 were not transplanted, 10 repeatedly cancelled their follow-up examination due to poor health). Mean time to follow-up examination was 147 days after HSCT. Goblet cell density before and after HSCT of all patients with evaluable pre-and post HSCT -examination was 52.6±7.5 vs. 43.9±4.1 cells/mm2 (Mean±SEM, p=0.46, n=8, wilcoxon’s signed rank) assessed with IC and 62.7±3.4 vs. 61.6 ±4.3 cells/mm2 (p=0.8, n=24) assessed with IVCM. 8 healthy subjects were examined via IVCM as control (mean age 38 years), mean goblet cell density was 74.8±4.3 cells/mm2.

 
Conclusions
 

IVCM showed goblet cell numbers in similar magnitude to the standard method IC, we therefore conclude that IVCM can also reliably be used. Conjunctival goblet cells did not show a significant decrease after HSCT. The time interval to follow-up examination may have been too short as most patients still were on immunosuppressants and only 2 had signs of oGvHD. Patients who present with oGvHD symptoms will be re-examined for goblet cell density in our clinic.

 
 
Figure A: Conjunctival Goblet Cells (arrows), Impression Cytology
 
Figure A: Conjunctival Goblet Cells (arrows), Impression Cytology
 
 
Figure B: Conjunctival Goblet Cells (arrows), In Vivo Confoal Microscopy
 
Figure B: Conjunctival Goblet Cells (arrows), In Vivo Confoal Microscopy
 
Keywords: 550 imaging/image analysis: clinical • 474 conjunctiva  
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