J Korean Ophthalmol Soc > Volume 57(11); 2016 > Article
Journal of the Korean Ophthalmological Society 2016;57(11):1706-1713.
DOI: https://doi.org/10.3341/jkos.2016.57.11.1706    Published online November 15, 2016.
Changes in Ocular Surface after Hematopoietic Stem Cell Transplantation.
Soonwon Yang, Hyun Seung Kim, Kyung Sun Na
Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea. drna@catholic.ac.kr
동종 조혈모세포이식 후 눈물막과 안구표면의 초기 변화
가톨릭대학교 의과대학 안과 및 시과학교실
To evaluate the prevalence of dry eye in patients before allogeneic hematopoietic stem cell transplantation (aHSCT) and changes in ocular surface in the acute stage after aHSCT. METHODS: We evaluated 56 eyes of 28 patients after aHSCT at a tertiary hospital. All patients underwent a full ophthalmic examination at 1 month before aHSCT (baseline) and 1, 2 and 3 months after aHSCT and answered the ocular surface disease index (OSDI) questionnaire to assess ocular involvement in the form of dry eye syndrome or any other ocular manifestation at each visit. Subjects were divided into 2 groups depending on the presence of dry eye at baseline. The main outcome measures were best-corrected visual acuity, tear break-up time, corneal fluorescein staining, Schirmer test, tear osmolarity and OSDI questionnaire. RESULTS: Dry eye was already present in 40 eyes of 20 patients (71.4%) suffering from hematological disease before aHSCT. Tear osmolarity was significantly increased at 1, 2 and 3 months after aHSCT compared with baseline in the dry eye group (each p < 0.01). Tear osmolarity also increased at 2 months after aHSCT and tear break-up time decreased at 3 months after aHSCT, which were statistically significant (p = 0.01 and p = 0.02, respectively). Other changes in ocular surface indices were not statistically significant. CONCLUSIONS: In the acute stage, changes in ocular surface indices such as Schirmer test and OSDI were not statistically significant. However, significant changes in tear osmolarity in both groups indicate that ophthalmic examination 1 or 2 months after aHSCT is recommended. Additionally, aggressive treatment is warranted when patients have dry eyes at baseline.
Key Words: Dry eye;Graft versus host disease;Tear osmolarity

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