Abstract
Purpose: :
To determine the role of Ocular Surface Disease Index (OSDI) in chronic ocular Graft- versus- Host Disease(oGVHD) patients.
Methods: :
Retrospective chart review of OSDI scores of 133 consecutive allogeneic stem cell transplant patients (evaluated from January to October 2007 at M.D Anderson Cancer Center Ophthalmology Clinic ) was performed. OSDI scores of patients who were diagnosed 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). Diagnostic criteria of chronic ocular GVHD included presence of systemic GVHD and presence of ocular symptoms (of dry eye syndrome), decreased schirmer’s scores, conjunctival inflammation, and other ocular surface diagnostic criteria as described in NIH GVHD consensus. Non-parametric tests (Wilcoxon rank sum test and Kruskal-Wallis test) were used to compare the difference in OSDI between C, N, and P groups.
Results: :
Of 133 patients, 41 had chronic OGVHD, 17 had no OGVHD, and 75 patients were pre-allogeneic stem cell transplantation. The mean OSDI score was highest among the chronic OGVHD group (C range 1.00 - 48.00; mean=21.66, SD=11.35) compared to those who did not have OGVHD (N range 0.00 - 24.00, mean=7.59, SD=3.14) and lowest among the pre transplant group (P range 0.00 - 11.00; mean=1.52, SD=3.14). There was a statistically significant difference in OSDI scores among all three groups (P<0.0001). The ODSI scores in C2 group are significantly higher than those in the N group (P=0.0001). The OSDI scores in the P group are significantly lower than those in the N group (P=0.0002).
Conclusions: :
Chronic OGVHD patients have statistically higher OSDI score when compared to stem cell transplantation patients who do not have the diagnosis of ocular GVHD and to those who are pretransplantation. OSDI may be a useful metric to assess chronic ocular GVHD patients.
Keywords: cornea: tears/tear film/dry eye • transplantation • cornea: clinical science