Clinical Observation Of Ocular Surface After Allogeneic Hematopoietic Stem Cell Transplantation

OBJECTIVE: To observe and compare the ocular surface conditions of patients with dry or non-dry eyes after allogeneic hematopoietic stem cell transplantation.METHODS: This cross-sectional study recruited 8patients(16 eyes)with non-dry eyes and 8 patients(16 eyes)with dry eyes after allogeneic hematopoietic stem cell transplantation.The basic conditions of the patients were in detail obtained to build a resource library for the study.OSDI questionnaire,Schirmer test,tear break-up time test,and sodium fluorescein staining were all conducted among the patients.Meanwhile,LipiView? Ocular Surface Interferometer was used to exam the thickness of tear-film lipid layer and obtain the infrared photograph of meibomian glands.Corneal nerves in patients were observed by corneal confocal microscopy.All data analyses were performed using the SPSS20.0 statistical software.RESULTS: There were no differences in sex and age between the dry eye group and the non-dry eye group.Compared with the non-dry eye group,the dry eye group had lower scores in OSDI questionnaire,shorter wet length of Schirmer test and tear break-up time,aswell as lower density of corneal nerve fibers(all P<0.05).Scores of the corneal staining in dry eye group were significantly higher than those in the non-dry eye group(P<0.05).Compared with the dry eye group,the average value of the thickness of tear-film lipid layer were higher and the eyelid gland loss rate was lower in non-dry eye group,but the differences were not statistically significant(both P>0.05).The corneal nerve curvature ranged from grade 2 to grade 3 in both groups(P>0.05).The density of corneal total branch node in the non-dry eye group was higher than that in the dry eye group with no statistical significance(P>0.05).CONCLUSIONS: OSDI-symptoms score and sodium fluorescein staining score were increased with less tear secretion,shorter tear film rupture time,and decreased corneal nerve density in patients with dry eye after allogeneic hematopoietic stem cell transplantation.The differences in the thickness of tear-film lipid layer and the eyelid gland loss rate as well as the density of corneal total branch node were small.Detailed observation of the ocular surface of the patients after allogeneic hematopoietic stem cell transplantation with accurate clinical diagnostic indicators is of great significance for early prevention,diagnosis and treatment of dry eye.