Journal List > J Korean Ophthalmol Soc > v.60(12) > 1139575

Beak, Ha, Yi, Yoo, Kim, and Na: Clinical Symptoms and Signs of Dry Eye Disease after Allogeneic Hematopoietic Stem Cell Transplantation

Abstract

Purpose

To identify the symptoms and signs of patients with dry eye disease (DED) after allogenic hematopoietic stem cell transplantation (HSCT) and analyze the correlations between these signs and symptoms.

Methods

We performed a retrospective study in 96 eyes of HSCT recipients with DED. Visual acuity, intraocular pressure, Schirmer test 1 (with anesthesia), tear osmolarity, tear break-up time, Ocular staining score (OSS, Oxford), and Ocular staining disease index (OSDI) were examined before and 1, 2, and 4 months after HSCT.

Results

A significant positive correlation was noted between changes in OSS and changes in OSDI. No ocular parameters showed significant correlations with Schirmer test values. Men more frequently described alleviation of symptoms greater than their objective results compared to women.

Conclusions

Subjective symptoms alone may be insufficient when diagnosing ocular graft-versus-host disease. We recommend regular ophthalmologic examination after allo-HSCT. In addition, a baseline ocular profile of tear dynamics and ocular surface parameters should be conducted before allo-HSCT.

Figures and Tables

Table 1

Baseline characteristics of patients before allogeneic HSCT

jkos-60-1148-i001

‘Ocular GVHD (−)’ means patients without ocular GVHD, ‘Ocular GVHD (+)’ means patients with ocular GVHD. Values are presented as mean ± standard deviation or number (%).

HSCT = hematopoietic stem cell transplantation; GVHD = graft-vs-host-disease; BCVA = best corrected visual acuity; IOP = intraocularpressure; OSS = ocular staining score; BUT = tear break up time; OSDI = Ocular Surface Disease Index.

*Student t-test; Fisher's exact test

Table 2

Comparison of changes in ocular surface and tear function before and after allogeneic HSCT between non-ocular and ocularGVHD groups

jkos-60-1148-i002

‘Ocular GVHD (−)’ means patients without ocular GVHD, ‘Ocular GVHD (+)’ means patients with ocular GVHD. ‘Base’ is showed beforeHSCT; ‘Post’ means 4 months after HSCT. Values are presented as number (%).

HSCT = hematopoietic stem cell transplantation; GVHD = graft-vs-host-disease; OSS = ocular staining score; BUT = tear break up time;OSDI = Ocular Surface Disease Index.

*Fisher's exact test.

Table 3

Association of ocular parameters with OSDI before and after HSCT

jkos-60-1148-i003

Values are presented as number (%) unless otherwise indicated.

OSDI = Ocular Surface Disease Index; HSCT = hematopoietic stem cell transplantation; CI = confidence interval; OSS = ocular stainingscore; BUT = tear break up time.

*Gamma coefficient.

Table 4

Association of ocular parameters with Schirmer score before and after HSCT

jkos-60-1148-i004

Values are presented as number (%) unless otherwise indicated.

HSCT = hematopoietic stem cell transplantation; CI = confidence interval; OSS = ocular staining score; BUT = tear break up time.

*Gamma coefficient.

Table 5

Baseline characteristics of groups divided by association with OSS and OSDI

jkos-60-1148-i005

Values are presented as mean ± standard deviation or number (%).

OSS = ocular staining score; OSDI = Ocular Surface Disease Index; DM = diabetes mellitus; HTN = hypertension.

*One-way analysis of variance; Fisher's exact test.

Notes

Conflicts of Interest The authors have no conflicts to disclose.

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