Ban Y, Ogawa Y, Goto E, Uchino M, Terauchi N, Seki M, Nakaya M, Saiki M, Mori T, Okamoto S, Matsumoto Y, Dogru M, Shimazaki J, Tsubota K
Department of Ophthalmology, School of Medicine, Keio University, Tokyo, Japan.
Eye (Lond). 2009 Jan;23(1):202-8. doi: 10.1038/eye.2008.340. Epub 2008 Nov 14.
To investigate the changes in the tear film lipid layer in haematopoietic stem cell transplantation (HSCT) patients with dry eye (DE) associated with chronic graft-vs-host disease (cGVHD) and compare with HSCT recipients without DE.
We performed a prospective study in 10 HSCT patients with DE associated with cGVHD and 11 HSCT recipients without DE. We performed Schirmer's test, tear film break up time examinations, ocular surface dye staining and meibum expressibility test and DR-1 tear film lipid layer interferometry. DR-1 interferometry images of the tear film surface were assigned a 'DR-1 grade' according to the Yokoi severity grading system. The DR-1 grades were analysed according to the presence or absence of DE, conjunctival fibrosis and systemic cGVHD.
The mean DR-1 severity grade in patients with DE related to cGVHD (DE/cGVHD group; 3.9+/-0.9) was significantly higher than in patients without DE after HSCT (non-DE/non-cGVHD group; 1.3+/-0.6; P<0.05). The DR-1 grade for HSCT recipients with conjunctival fibrosis was significantly higher than in patients without conjunctival fibrosis (P<0.05). When DE severity was graded according to the recommendation of the 2007 Dry Eye Workshop Report, our results showed a correlation between the severity of DE and DR-1 grades (r=0.8812, P<0.0001).
DR-1 interferometry may be applicable to diagnosing DE and evaluating its progression subsequent to HSCT.
研究造血干细胞移植（HSCT）合并慢性移植物抗宿主病（cGVHD）的干眼症（DE）患者泪膜脂质层的变化，并与无DE的HSCT受者进行比较。
我们对10例合并cGVHD的DE的HSCT患者和11例无DE的HSCT受者进行了一项前瞻性研究。我们进行了泪液分泌试验、泪膜破裂时间检查、眼表染色和美膜表达试验以及DR-1泪膜脂质层干涉测量。根据横井严重程度分级系统，为泪膜表面的DR-1干涉测量图像指定一个“DR-1等级”。根据是否存在DE、结膜纤维化和全身性cGVHD对DR-1等级进行分析。
与cGVHD相关的DE患者（DE/cGVHD组；3.9±0.9）的平均DR-1严重程度等级显著高于HSCT后无DE的患者（非DE/非cGVHD组；1.3±0.6；P<0.05）。有结膜纤维化的HSCT受者的DR-1等级显著高于无结膜纤维化的患者（P<0.05）。当根据2007年干眼症研讨会报告的建议对DE严重程度进行分级时，我们的结果显示DE严重程度与DR-1等级之间存在相关性（r=0.8812，P<0.0001）。
DR-1干涉测量法可能适用于诊断DE并评估HSCT后其进展情况。
