J Korean Ophthalmol Soc.  2016 Nov;57(11):1706-1713. 10.3341/jkos.2016.57.11.1706.

Changes in Ocular Surface after Hematopoietic Stem Cell Transplantation

• Yang S
• Kim HS
• Na KS

• KMID: 2357725
• DOI: http://doi.org/10.3341/jkos.2016.57.11.1706

Abstract

PURPOSE
To evaluate the prevalence of dry eye in patients before allogeneic hematopoietic stem cell transplantation (aHSCT) and changes in ocular surface in the acute stage after aHSCT.
METHODS
We evaluated 56 eyes of 28 patients after aHSCT at a tertiary hospital. All patients underwent a full ophthalmic examination at 1 month before aHSCT (baseline) and 1, 2 and 3 months after aHSCT and answered the ocular surface disease index (OSDI) questionnaire to assess ocular involvement in the form of dry eye syndrome or any other ocular manifestation at each visit. Subjects were divided into 2 groups depending on the presence of dry eye at baseline. The main outcome measures were best-corrected visual acuity, tear break-up time, corneal fluorescein staining, Schirmer test, tear osmolarity and OSDI questionnaire.
RESULTS
Dry eye was already present in 40 eyes of 20 patients (71.4%) suffering from hematological disease before aHSCT. Tear osmolarity was significantly increased at 1, 2 and 3 months after aHSCT compared with baseline in the dry eye group (each p < 0.01). Tear osmolarity also increased at 2 months after aHSCT and tear break-up time decreased at 3 months after aHSCT, which were statistically significant (p = 0.01 and p = 0.02, respectively). Other changes in ocular surface indices were not statistically significant.
CONCLUSIONS
In the acute stage, changes in ocular surface indices such as Schirmer test and OSDI were not statistically significant. However, significant changes in tear osmolarity in both groups indicate that ophthalmic examination 1 or 2 months after aHSCT is recommended. Additionally, aggressive treatment is warranted when patients have dry eyes at baseline.

Keyword

Dry eye; Graft versus host disease; Tear osmolarity

MeSH Terms

Dry Eye Syndromes
Fluorescein
Graft vs Host Disease
Hematologic Diseases
Hematopoietic Stem Cell Transplantation*
Hematopoietic Stem Cells*
Humans
Osmolar Concentration
Outcome Assessment (Health Care)
Prevalence
Tears
Tertiary Care Centers
Visual Acuity
Fluorescein

Reference

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