School of Natural Sciences, University of Western Sydney, Sydney, Australia.
Bone Marrow Transplant. 2012 Jan;47(1):115-9. doi: 10.1038/bmt.2011.36. Epub 2011 Mar 7.
The purpose of this study was to compare tear physiology characteristics of chronic GVHD (cGVHD)-associated dry eye to dry eye caused by Sjogren's syndrome (SS), a extreme form of aqueous-deficient dry eye, and meibomian gland dysfunction (MGD), the major cause of evaporative dry eye. Tear turnover rate, evaporation and osmolarity along with meibomian gland dropout and lipid layer interferometric patterns were assessed in the right eyes of 12 patients with dry eye associated with cGVHD, 12 age-matched patients with SS and 12 age-sex matched subjects with MGD. In cGVHD, the decrease in tear turnover rate was similar (P=0.33), but the number of non-functioning meibomian glands was significantly higher (P<0.01) than in SS. Tear evaporation rate in cGVHD dry eye was found to be similar to that in MGD (P=0.36) and significantly higher than in SS (P<0.01). The lipid layer was most unstable in cGVHD compared with other groups. There was no variation in tear volume across all groups. Although statistical significance was not detected, the mean tear osmolarity (333.51±14.67mOsm/L) was highest in cGVHD. Major aspects of tear physiology were severely impaired in cGVHD-associated dry eye.
本研究旨在比较与慢性移植物抗宿主病（cGVHD）相关的干眼、干燥综合征（SS）引起的极度水样液缺乏性干眼和睑板腺功能障碍（MGD）这三种不同类型干眼的泪液生理特征。评估了 12 例 cGVHD 相关干眼患者、12 例年龄匹配的 SS 患者和 12 例年龄性别匹配的 MGD 患者右眼的泪液周转率、蒸发率和渗透压以及睑板腺缺失和脂质层干涉模式。在 cGVHD 中，泪液周转率的降低相似（P=0.33），但功能失调的睑板腺数量明显更高（P<0.01）。cGVHD 干眼的泪液蒸发率与 MGD 相似（P=0.36），明显高于 SS（P<0.01）。与其他组相比，cGVHD 组的脂质层最不稳定。三组的泪液体积均无变化。尽管未检测到统计学意义，但 cGVHD 的平均泪液渗透压（333.51±14.67mOsm/L）最高。cGVHD 相关干眼的泪液生理的主要方面受到严重损害。
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