Abstract
Purpose :
Neurotrophic keratopathy (NK) is a degenerative disorder of the cornea characterized by decreased sensory innervation, epitheliopathy, and impaired epithelial healing. In this study, we performed an objective assessment of ocular pain and quality-of-life-related parameters in ocular graft-versus-host disease (oGVHD) patients with or without NK.
Methods :
We included 184 oGVHD patients in this retrospective study, including 29 patients with NK defined as decreased corneal sensation as assessed by Cochet-Bonnet esthesiometer. We assessed their records for ocular pain assessment survey (OPAS) scores and clinical parameters, including corneal sensation, corneal fluorescein staining (CFS) score, Schirmer’s test, tear break-up time (TBUT), and ocular surface disease index (OSDI) score.
Results :
oGVHD patients with NK had lower corneal sensation (3.4±1.4 vs. 5.9±0.3, p≤0.0001), higher CFS scores (6.4±4.2 vs. 4.7±4.0, p=0.040), and lower TBUT scores (1.2±2.1 vs. 2.2±3.1, p=0.049) compared to oGVHD patients without NK and additionally had significantly higher ocular pain intensity scores (OPAS 24 hour average eye pain intensity: 2.0±2.8 vs. 1.1±1.9, p=0.03). Patients with NK more commonly reported burning (0.2±0.3 vs. 0.3±0.4, p=0.021) and sensitivity to light (0.2±0.3 vs. 0.3±0.4, p=0.049) as compared to patients without NK.
Conclusions :
Clinical signs of ocular surface disease are worse in oGVHD patients with NK than in oGVHD patients without NK. These patients experience higher intensity ocular pain and lower quality of life-related parameters.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.