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Giulia Coco, Ahmad Kheirkhah, Vannarut Satitpitakul, Reza Dana; Limbal and Conjunctival Epithelial Thickness in Ocular Graft-versus-Host Disease. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5716. doi: https://doi.org/.
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To compare limbal and conjunctival epithelial thickness in patients with dry eye disease with or without ocular graft-versus-host disease (GVHD).
In this cross-sectional study, we enrolled 40 patients with moderate or severe dry eye disease, among which 20 patients with chronic ocular GVHD and 20 non-GVHD patients as the control group. All patients had a comprehensive ophthalmic assessment, including corneal and conjunctival staining, tear break-up time, Schirmer test, and meibography. A spectral domain optical coherence tomography (RTVue-100, OptoVue, Fremont, CA) was used to measure the thickness of the limbal epithelium, as well as the bulbar conjunctival epithelium at 1, 2, 3, and 4 mm posterior to the limbus. Measurements were performed nasally and temporally in both eyes.
The average thickness of limbal epithelium was 65.9 ± 12.6 µm (mean ± SD) temporally and 69.4 ± 11.4 µm nasally (P=0.01). The average thickness of bulbar conjunctival epithelium was 57.0 ± 12.3 µm temporally and 60.2 ± 11.2 µm nasally (P=0.06). There were no statistically significant differences between GVHD and non-GVHD groups in thickness of limbal epithelium (70.0 ± 12.4 vs. 65.8 ± 6.7 µm, respectively, P=0.20) or bulbar conjunctival epithelium (59.3 ± 9.9 vs. 58.2 ± 10.6 µm, respectively, P=0.99). There was a significant correlation between limbal and conjunctival epithelial thickness (P=0.002, Rs=0.35). Also a statistically significant negative correlation was observed between limbal epithelial thickness and age (P=0.002, Rs= -0.35). There were no other significant correlations between limbal or bulbar conjunctival epithelial thickness and other clinical parameters.
There are regional variations in thickness of the ocular surface epithelia. However, no difference is present in this parameter between eyes with or without ocular GVHD.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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