Abstract
Purpose :
To compare epithelial thickness in patients who developed ocular Graft Versus Host Disease (definite oGVHD) after hematopoietic stem cell transplantation (HSCT), and those who did not (none oGHVD).
Methods :
In this retrospective chart review, patients with GVHD who underwent corneal epithelial thickness mapping at the Illinois Eye and Ear Infirmary between July 1, 2021 and October 15, 2021 were identified. Records were reviewed for corneal epithelial thickness data measured by optical coherence tomography (Optovue Avanti), Schirmer 1 test without anesthetic, corneal and conjunctival staining, and ocular surface disease index (OSDI) scores. Mean ± SD values of each corneal epithelial thickness variable (central 2mm, superior epithelial thickness 2-7mm, inferior epithelial thickness 2-7mm, standard deviation) were calculated for the definite and none oGHVD groups. Correlations of epithelial thickness and standard deviation to the signs and symptoms of dry eye were calculated.
Results :
There were 136 definite oGVHD eyes and 40 none oGVHD eyes. The mean (± SD) central, superior, and inferior corneal epithelial thicknesses were 50.90 (± 6.60) um, 46.08 (± 7.21) um, and 52.15 (± 6.81) um in the definite oGHVD group, and 51.96 (± 4.01) um, 48.6 (± 4.71) um, and 53.36 (± 4.72) um in the none oGVHD group. The superior corneal epithelium was thinner in definite oGVHD eyes compared to none oGVHD eyes (p = 0.048), while there was no statistical difference in central or inferior epithelium. The variability of epithelial thickness (measured as standard deviation) was higher in definite oGVHD eyes (4.64 ± 2.23) compared to none oGVHD eyes (2.90 ± 1.08; p < 0.0001). OSDI scores were higher for patients with definite oGVHD (28.29 ± 23.79) compared to those without oGVHD (14.12 ± 17.21; p = 0.001). OSDI scores negatively correlated with superior epithelial thickness (Pearson coefficient = -0.207, p = 0.007) and positively correlated with epithelial thickness variability (Pearson coefficient = 0.228, p = 0.003).
Conclusions :
In this series, eyes with definite oGHVD exhibited thinner superior corneal epithelial thicknesses and higher variability in epithelial thickness compared to eyes without oGVHD. Corneal epithelial mapping may be an objective and efficient method of diagnosing ocular GVHD.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.