title: [Assessment of lipid layer thickness of tear film in the diagnosis of dry-eye syndrome in children after the hematopoietic stem cell transplantation].
abstract: Dry eye syndrome (DES), also known as keratoconjunctivitis sicca (KCS) is recognized as the most frequent ocular complication after allogeneic stem cell transplantation (allo-SCT). KCS can appear either due to insufficient tear production or excessive tear evaporation, both resulting in tears hyperosmolarity that leads to ocular damage. The evaporation rate and better film stability is determined primarily by the status of the lipid layer.
  
  
  OBJECTIVE
  Observation and classification of tear film lipid layer interference patterns in normal and dry eyes in patients after allogeneic stem cell transplantation with a follow-up time of 6 months-5 years (median 26.54 months).
  
  
  METHODS
  Investigation of the relation between the lipid layer interference patterns in normal and dry eyes and the results of other dry eye examinations and complaints. Relation between DES and conditioning regimes, including total body irradiation and high-dose chemotherapy, immunosuppressive drugs, the time after allogeneic stem cell transplantation and chronic graft-versus-host disease. Precorneal tears lipid layer interference patterns, were examined in 114 eyes in treatment group with the Tearscope-plus. Patient with dry eye were identified on the basis of Schirmer test scores and/or tear breakup time, and positive lissamine and/or fluorescein staining.
  
  
  RESULTS
  42 of 114 eyes (36.8%) developed DES after allo-SCT A significant correlation between thickness of lipid layer and BUT, Schirmer test, lissamine green and fluorescein staining was found in the treatment group. A significant association was found between present chronic GVHD and DES in children. DES was not associated with TBI, corticosteroids, immunosuppressive drugs and the time in the present study.
  
  
  CONCLUSIONS
  Tears lipid layer interference patterns are highly correlated with the diagnosis of DES. Tears lipid layer interference patterns ( noninvasive method), can be used to diagnose early DES in children after allo-SCT. Chronic GVHD play a major role in development of DES. dry eye syndrome, graft versus host disease, stem cell transplantation.
authors.affiliation: Z Katedry i Kliniki Okulistyki Akademii Medycznej we Wrocławiu. mkurpinska@op.pl
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Kurpińska
authors.forename: Ewa
authors.initials: E
authors.lastname: Gorczyńska
authors.forename: Joanna
authors.initials: J
authors.lastname: Owoc-Lempach
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Bernacka
authors.forename: Marta
authors.initials: M
authors.lastname: Misiuk-Hojło
authors.forename: Alicja
authors.initials: A
authors.lastname: Chybicka
mesh_terms: D000293:Adolescent; D002648:Child; D003941:Diagnostic Techniques, Ophthalmological; D015352:Dry Eye Syndromes / Q000175:diagnosis* / Q000209:etiology* / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007765:Lacrimal Apparatus / Q000378:metabolism*; D050356:Lipid Metabolism; D008297:Male; D009369:Neoplasms / Q000628:therapy; D013666:Tears / Q000378:metabolism*; D055815:Young Adult