[Dry eye in graft-versus-host disease].
OBJECTIVE
To investigate patients who had ocular presentations after allogeneic hematopoietic stem cell transplantation.


METHODS
The eyes of 20 patients of leukemia who had undergone allogeneic hematopoietic stem cell transplantation were examined. The ocular surface of these patients was examined by slit-lamp. The eye examination also included evaluation of tear break-up time, Schirmer tests with and without nasal stimulation, and fluorescein staining, rose bengal staining, etc. Conjunctival impression cytology and pathological examination of surgical specimens from 3 patients were performed.


RESULTS
Fourteen of 20 patients developed chronic graft-versus-host disease (cGVHD). Eight patients suffered from dry eye accompanied by GVHD simultaneously. The incidence of dry eye in GVHD was 57%. Among them, 4 cases were severe dry eye associated with significant decrease of visual acuity and even development of corneal ulcer. Ophthalmic pathology findings were as follows: loss of conjunctival goblet cells or significant reduction in amount; conjunctival and corneal epithelial keratinization and squamous metaplasia; and dominance of T cell in conjunctival inflammatory infiltration cells.


CONCLUSIONS
Dry eye is the major ocular complication after allogeneic hematopoietic stem cell transplantation. It affected the patients' life quality severely. The high incidence and potentially severe ocular problems in these patients suggest that close ophthalmic monitoring is important in allogeneic hematopoietic stem cell transplantation.
Fei
Wen-lei
WL
Zhongshan Ophthalmic Center, Zhongshan University, Guangzhou 510060, China.
Chen
Jia-qi
JQ
Du
Xin
X
Liu
Yan-hui
YH
Sun
Ming-xia
MX
Lin
Jian-xian
JX
Weng
Jian-yu
JY
Luo
Tian-zhen
TZ
Yin
Dong-ming
DM
Luo
Xiao-yang
XY
D000328:Adult; D003937:Diagnosis, Differential; D015352:Dry Eye Syndromes / Q000209:etiology*; D005260:Female; D006086:Graft vs Host Disease / Q000150:complications* / Q000473:pathology; D006801:Humans; D007938:Leukemia / Q000628:therapy*; D008297:Male; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D014184:Transplantation, Homologous