Abstract
Purpose :
Purpose: Ocular graft-versus-host disease (GVHD) is known to occur in 30-70% of patients after allogeneic haematopoietic stem cell transplantation (HSCT). It mainly affects the ocular surface and is characterized by decreased conjunctival goblet cell density, increased conjunctival squamous metaplasia and infiltration of tissues with inflammatory cells. These ocular manifestations can lead to painful non-healing corneal ulcers, secondary infections and visual loss. To understand long-term ophthalmic outcomes in chronic ocular GVHD, we evaluated the ocular surface changes of post-HSCT patients in relation to dry eye-related symptoms.
Methods :
Methods: This prospective observational study was approved by the Institutional Review Board of The University of Hong Kong/Hospital Authority Hong Kong West Cluster. Recruited HSCT patients were checked on best-corrected visual acuity, intraocular pressure (IOP), specular microscopy, anterior eye segment tomography, and slit lamp examinations to confirm the absence of pre-existing ocular inflammatory diseases. Dry-eye-related ocular surface parameters were measured by keratography before and 12 months post-HSCT. The Ocular Surface Disease Index (OSDI) and Dry Eye-Related Quality-of-Life Score (DEQS) questionnaire investigated subjective symptoms of dry eye. Statistical Analyses were conducted on R.
Results :
Results: 50 eyes of 25 patients were included in this study. Non-parametric paired samples Wilcoxon test was conducted to compare ocular surface performance pre-HSCT and 1-year post-HSCT. A statistically significant decrement of mean difference was found in non-invasive tear break-up time (-3.53 seconds, p = 0.002269) and tears meniscus height (-0.041 mm, p = 0.008862). On the other hand, there was a statistically significant increment in the mean difference in the redness score (+0.13 unit, p = 0.01756) and DEQS score (+6.19 weighted score, p = 0.03713).
Conclusions :
Conclusions: The findings of this study inform on the long-term ophthalmic outcomes of post-HSCT patients.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.