Analysis Of Manifestations And Risk Factors In Ocular Graft-Versus-Host Disease Cases Following Allogeneic Peripheral Blood Stem Cells Transplantation

Objctive:To analyse the clinical feature and risk factors of ocular graft-versus-host disease (GVHD) after allogeneic peripheral blood stem cells transplantation (allo-PBSCT) and provide scientific data to prevent ocular GVHD.Method:Retrospective, noncomparative, observational clinical study of patients who received allo-PBSCT from Oct.2010 to Nov.2014 in 307 Hospital of PLA. The patients who accepted only one time successful transplantation were enrolled.All patients had received OSDI questionnaire and complete ophthalmologic examination, including visual acuity, tonometry, Schirmer I test,BUT,CSF and fudus examination.We registered ophthalmologic and hematological data, including the. indication for allo-PBSCT, occurrence of systemic and ocular GVHD, ocular manifestations,donar situation.Result:According to the diagnosis standard of N1H, ocular GVHD developed in 70.8% of 89 patients(male=61,female=28,mean age 34.5 ± 12.0yr).In these patients,3 cases in degree 1,11cases in degree 2,17cases in degree 3and 27cases in degree 4.The clinical symptoms were varied. Dry eye was the most common complaint(56cases、 88.9%),followed by foreign body sensation (53cases,84.1%)、photophobia(31 cases、 44.9%) and burning(29cases.46.0%).Ocular GVHD could affect nearly all region of eye-ball. S Ⅰ t、BUT was obviously deceased in ocualr GVHD group than non-oGVHD group (P<0.001),while CSFscores were significantly higher than in ocualr GVHD group than non-oGVHD group (P<0.001).Chronic skin GVHD was strongly associated with ocular GVHD (P<0.001). Blood types mismatch was related with the occurrence of ocular GVHD(P=0.019,OR=0.35,Cl=0.12-0.85),and it could influence severe degree(P=0.021, OR=0.27, CI=0.09-0.82)Conclusion:Ocular GVHD was a common complication of allo-PBSCT. severe cases took a high proportion.Ocular GVHD could affect conjunctive,cornea,larcrimal gland,cataract. rentina. It showed multiple symptoms,dry eye and foreign body sensation were the most common complaint. Chronic skin GVHD showed a strong association with oGVHD. Blood types mismatch was the risk factor for the development and worsen of ocular GVHD.