Study And Analysis Of Ocular Surface Injury In Patients Undergoing Allogeneic Bone Marrow Transplantation

Objective: To collect preoperative and postoperative ocular surface observation indicators in patients undergoing allogeneic peripheral hematopoietic stem cell transplantation(Allo HSCT),and to explore the characteristics of ocular surface changes in ocular graft-versus-host disease(oGVHD)and their relationship with HSCT and GVHD.Method: Fifteen patients(30 eyes)who underwent Allo HSCT at the Hematology Department of the First Affiliated Hospital of Xinjiang Medical University from January2021 to July 2022 were included in the present study.Patients were followed up for a period of 6 months(before transplantation,1 month,3 months,and 6 months after transplantation).We collected and analyzed baseline patient information,donor recipient matching,incidence of oGVHD,and various ophthalmic examination findings using SPSS25.0 software to calculate the incidence of oGVHD Correlation analysis of changes in ocular surface indicators before and after Allo HSCT,and analysis of risk factors affecting the occurrence of oGVHD.Result: A total of 15 Allo HSCT patients(30 eyes)who met the inclusion and exclusion criteria were collected.According to the diagnostic and grading criteria published by the 2013 International Consensus Group on Chronic oGVHD,8 cases(53.3%)developed oGVHD.Among them,1 case was mild/moderate,and 7 cases were severe.There are various manifestations of GVHD in the eyes,including5 cases of dry eye(33.3%),5 cases of redness(33.3%),4 cases of decreased vision(26.7%),4 cases of photophobia(26.7%),4 cases of foreign body sensation(26.7%),and1 case of eye pain(6.67%).The SIt and BUT of patients with ocular GVHD were significantly lower than those without oGVHD(P<0.001),and the CFS of patients with oGVHD was significantly higher than those without oGVHD(P<0.001).There was no statistical difference(P>0.05)in the correlation test between the occurrence of oGVHD and patient gender,ethnicity,underlying disease,donor recipient blood type,and matching.The difference between the age of the patient and the occurrence of oGVHD was statistically significant(P=0.038<0.05);There is a statistical difference between whether the patient has GVHD in other organs of the body and whether oGVHD occurs(P=0.025 < 0.05);OGVHD often occurs 6 months after Allo HSCT surgery.Conclusion: oGVHD is a common postoperative complication of Allo HSCT,and the proportion of severe cases is relatively high.The clinical manifestations of ocular GVHD are diverse,with dry eyes and photophobia being the most common.Older patients with GVHD in other organs of the body are risk factors for ocular GVHD.The 6th month after Allo HSCT surgery can serve as a time point for postoperative observation,which may be of great significance for early detection and diagnosis of oGVHD.