Analysis of factors related to refractive changes around onset of dry eye disease caused by chronic graft-versus-host-disease after hematopoietic stem cell transplantation

Abstract

Purpose : Recently, there is an increasing number of populations in myopia worldwide, and myopia prevention is known as an urgent task. We explored that chronic inflammation in chronic graft-versus-host disease (cGVHD)-related dry eye disease (DED) is associated with refractive changes before and after hematopoietic stem cell transplantation (HSCT) and the onset of DED. Purpose of the study is to investigate whether chronic inflammation in cGVHD-related DED is associated with refractive changes after HSCT and the onset of DED, and explore some factors related to refractive changes with DED caused by cGVHD.

Methods : We retrospectively investigated HSCT recipients who visited at DED outpatient clinic, Keio University hospital from March 2017 to February 2018. We selected patients between 18 and 40 years of age at the time of HSCT. We divided the recipients into groups: 1) newly developed 27 DED patients after HSCT (mean age 31.19±6.89) and 2) non-DED 30 patients after HSCT (mean age 32.73±6.25).

Results : Myopic changes were observed significantly among the DED group (p<0.05: χsquare test). It occurred in 63% of the DED group, instead of 18% of the control group. Mean refractive changes were -0.68±0.64D for right eye, and - 0.66±0.63D for left eye. We found that there is difference between the area of corneal epithelial disorder, and inferior disorder especially occurred in the cases with refractive changes, compared to the central and superior disorder (p<0.05).

Conclusions : The frequency of myopic changes in the cGVHD-related DED patients were significantly higher than that of the controls. Since corneal epithelial disorder of central location was significantly low than that of inferior location, corneal disorder might not influence the refractive change among some factors related to myopia in the cGVHD patients.

This is a 2020 ARVO Annual Meeting abstract.