Steger B, Speicher L, Philipp W, Bechrakis N E
Department of Ophthalmology, Medical University of Innsbruck, Innsbruck, Austria.
Br J Ophthalmol. 2015 Feb;99(2):160-5. doi: 10.1136/bjophthalmol-2014-305072. Epub 2014 Aug 19.
To first describe in vivo confocal microscopic (IVCM) corneal findings in severe dry eye syndrome due to ocular chronic graft versus host disease (cGvHD) after allogeneic stem cell transplantation.
IVCM of the central cornea was performed in 12 prospectively recruited patients with severe ocular cGvHD associated dry eye syndrome and in six control patients with haematological malignancies without cGvHD. Within each examined corneal layer, at least three non-overlapping areas were selected for representative analysis.
The number of sub basal nerve branches was markedly reduced in patients with cGvHD. Sub basal nerve morphology was characterised by increased tortuosity and reduced reflectivity. Accumulation of hyper-reflective extracellular matrix, significantly increased haze and increased keratocyte density were found in the anterior stroma of the study group.
IVCM findings of the cornea in patients with severe ocular cGvHD include a rarefaction of the sub basal corneal nerve plexus and dense accumulation of hyper-reflective extracellular matrix in the anterior stroma.
首次描述异基因干细胞移植后因眼部慢性移植物抗宿主病（cGvHD）导致的严重干眼综合征的体内共焦显微镜（IVCM）角膜表现。
对12例前瞻性招募的患有严重眼部cGvHD相关干眼综合征的患者以及6例无cGvHD的血液系统恶性肿瘤对照患者进行中央角膜的IVCM检查。在每个检查的角膜层内，选择至少三个不重叠的区域进行代表性分析。
cGvHD患者的基底神经分支数量明显减少。基底神经形态的特征是弯曲度增加和反射率降低。在研究组的前基质中发现高反射性细胞外基质积聚、 haze明显增加和角膜细胞密度增加。
严重眼部cGvHD患者角膜的IVCM表现包括基底角膜神经丛稀疏和前基质中高反射性细胞外基质的密集积聚。
