Abstract
Purpose:
To report whether low Schirmer testing scores are predictive of ocular surface findings in patients with chronic graft-versus-host disease (cGVHD) diagnosed after hematopoietic cell transplantation.
Methods:
Retrospective study of 429 consecutive patients with cGVHD referred for ophthalmic examination between 1990 and 2006. Office visit records were reviewed for extraction of data including visual acuity, Schirmer testing scores, slit-lamp biomicroscopic findings (including corneal staining with fluorescein), and fundoscopic abnormalities. In this analysis, we considered the relationship between Schirmer testing scores and corneal staining. Two arbitrary cutoff values were used to define ‘low’ Schirmer scores, 5mm or less and 10mm or less. Analysis was then performed to determine if there was an association between ‘low’ scores and corneal surface staining.
Results:
In our population of patients with cGVHD, Schirmer testing scores of 5 mm or less are associated with presence of corneal fluorescein staining (p<0.0001). Of those patients with Schirmer scores of 5 mm or less, 44.4% were found to have corneal staining versus 12.5% of patients with scores greater than 5 mm. Similarly, Schirmer testing scores of 10 mm or less are also associated with the presence of corneal fluorescein staining (p<0.0001). Of those patients with Schirmer scores of 10 mm or less, 32.7% were found to have corneal staining versus 7.1% of patients with scores greater than 10 mm.
Conclusions:
Schirmer testing scores of 5mm or less and 10mm or less are associated with presence of corneal fluorescein staining in our population of patients with cGVHD.
Keywords: 482 cornea: epithelium