Abstract
Purpose: :
Corneal surface videokeratoscopic indices (VKI) are abnormal in some ocular surface diseases. VKI in chronic OGVHD is unknown. Current study is to describe corneal surface VKI in chronic ocular graft vs. host disease (OGVHD) patients.
Methods: :
IRB approval was obtained. Retrospective chart review of 166 allogeneic stem cell transplant patients evaluated from August 2007 to August 2008 at M.D Anderson Cancer Center Ophthalmology Clinic was performed. Their videokeratoscopic indices, surface regularity index (SRI) and surface asymmetry index (SAI), were reviewed, along with ocular surface disease index (OSDI) and Schirmer scores. Patients with chronic OGVHD (C) were compared to those who did not have chronic OGVHD (N) and to those who were evaluated prior to their allogeneic stem cell transplantation (P). NIH GVHD consensus diagnostic criteria of chronic OGVHD were used. Differences between the groups were assessed by one-way ANOVA followed by the Tukey Honest Significant Difference for Unequal N post-hoc test.
Results: :
Of the 166 patients, 50 patients were pre-allogenic stem cell transplantation (P), 59 patients had no OGVHD (N) and 57 patients had chronic OGVHD (C). The mean SRI was highest in C (mean=0.71, SD=0.37) and showed statistically significant difference compared to N (mean=0.39, SD 0.28, P=0.000022) and P (mean=0.29, SD=0.18, p=0.000022). There was no significant difference in the SRI of the N versus P (P=0.22). Similarly, the mean SAI was highest in group C (mean=1.02, SD=0.69) compared to N (mean=0.48, SD=0.25, P=0.000022)) and to P (mean=0.37, SD=0.14, P=0.000022). There was no significant difference in the SAI between N and P (P=0.46). OSDI was significantly higher in group C compared to N (P=0.00022) and P (P=0.00022). Schirmer score was lower in group C (mean=5.01, SD=6.80) compared to N (mean=15.14, SD=9.72) and highest in P (mean=21.16, SD=9.25). Schirmer score was significantly different between the three groups (P vs. C: p=0.00022; P vs. N: p=0.0026: C vs. N p=0.00022).
Conclusions: :
Chronic OGVHD patients have significantly higher videokeratoscopic indices, along with expected higher OSDI and lower Schirmer score compared to those without ocular GVHD and pre-transplantation patients. Videokeratocopic indices may be a useful metric to assess chronic ocular GVHD patients.
Keywords: cornea: tears/tear film/dry eye • transplantation • cornea: clinical science