Baseline profiles of ocular surface and tear dynamics after allogeneic hematopoietic stem cell transplantation in patients with or without chronic GVHD-related dry eye

• Published in: Bone marrow transplantation (Basingstoke) Vol. 45; no. 6; pp. 1077 - 1083
• Main Authors: Wang, Y, Ogawa, Y, Dogru, M, Tatematsu, Y, Uchino, M, Kamoi, M, Okada, N, Okamoto, S, Tsubota, K
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.06.2010; Nature Publishing Group
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Bone marrow; Bone marrow, stem cells transplantation. Graft versus host reaction; Case-Control Studies; Cell Biology; Cell density; Chronic Disease; Conjunctiva - pathology; Conjunctivitis - etiology; Cornea; Cytology; Diagnosis; Dry eye syndromes; Evaluation; Evaporation; Evaporation rate; Eye; Eye (anatomy); Eye care products; Female; Goblet Cells - pathology; Graft versus host reaction; Graft vs Host Disease - pathology; Graft vs Host Disease - prevention & control; Hematologic Diseases - complications; Hematologic Diseases - therapy; Hematology; Hematopoietic Stem Cell Transplantation - adverse effects; Hematopoietic Stem Cell Transplantation - methods; Hematopoietic stem cells; Humans; Inflammation; Internal Medicine; Male; Medical sciences; Medicine; Medicine & Public Health; Metaplasia; Middle Aged; original-article; Public Health; Risk factors; Sensitivity analysis; Stem cell transplantation; Stem Cells; Tears; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation; Transplantation, Homologous; Xerophthalmia - etiology; Xerophthalmia - pathology; Young Adult; Japan; impression cytology; brush cytology; tear evaporation; dry eye; meibomian gland; allogeneic hematopoietic stem cell transplantation (HSCT); Human; Immunopathology; Graft versus host disease; Hematology; Stem cell; Cytology; Hematopoietic cell; Homograft; Evaporation; Eye; Visual system; Dry eye syndrome; Eye disease; Chronic; Allogeneic hematopoietic stem cell transplantation; Dynamics; Dry eye; Hematopoietic stem cell transplantation
• ISSN: 0268-3369; 1476-5365; 1476-5365
• DOI: 10.1038/bmt.2009.312

We evaluated ocular surface alterations in allogeneic hematopoietic stem cell transplantation (HSCT) recipients with or without chronic GVHD-related dry eye in a prospective study. Fifty eyes of 25 post-HSCT patients and 28 eyes of 14 age-matched healthy controls were included. Meibomian gland (MG) obstruction, tear evaporation rate, corneal sensitivity (CS), Schirmer test-I, tear break-up time (BUT) and ocular surface vital staining were examined. Conjunctival impression and brush cytology specimens were collected to evaluate the goblet cell density (GCD) and the inflammatory cell numbers. Obvious MG obstruction, decreased CS and enhanced tear evaporation rate were found in post-HSCT patients compared with normal controls. In addition, decreased conjunctival GCD, increased conjunctival squamous metaplasia and inflammatory cells were noted in cGVHD-related dry eyes compared with normal controls and post-HSCT without dry eye subjects. Furthermore, the conjunctival inflammatory cells were significantly higher in severe dry eyes compared with mild dry eyes ( P =0.03). We found comprehensive ocular surface alteration in post-HSCT patients, regardless of whether they had cGVHD-related dry eye or not. The results suggest that the extent of inflammatory process seems to have a pivotal role in the outcome of the cGVHD-related dry eye.