Engel L A, Wittig S, Bock F, Sauerbier L, Scheid C, Holtick U, Chemnitz J-M, Hallek M, Cursiefen C, Steven P
1] Department of Ophthalmology, University of Cologne, Cologne, Germany [2] Ocular GvHD Competence Center, University of Cologne, Cologne, Germany.
1] Department of Ophthalmology, University of Cologne, Cologne, Germany [2] CORIC (Cologne Ophthalmological Reading and Image Analysis Center), Department of Ophthalmology, University of Cologne, Cologne, Germany.
Bone Marrow Transplant. 2015 Jul;50(7):961-7. doi: 10.1038/bmt.2015.72. Epub 2015 Apr 20.
Meibomian gland loss in ocular GvHD was described as a mechanism contributing to dry eye and severe damage to the ocular surface. Infrared images of upper eyelid meibomian glands from 86 ocular GvHD patients, from 10 patients after allogeneic stem cell transplantation (aSCT) without ocular GvHD, from 32 patients prior to aSCT and from 30 healthy controls were analyzed retrospectively and evaluated using two grading schemes. The upper meibomian gland area (uMGA) was calculated and set in relation to the total tarsal area of the lid. Results demonstrate that meibomian gland loss is significantly increased in patients with ocular GvHD as well as in patients prior to aSCT in comparison with controls (P between 0.05 and <0.001). Patients after aSCT without ocular GvHD had no significant difference in uMGA in comparison with controls. This study suggests that meibomian gland loss in GvHD patients is likely to be a multifactorial process that also occurs prior to aSCT, possibly due to underlying diseases and/or secondary to chemotherapy or irradiation. In addition, the question has to be addressed whether meibomian gland loss could serve as a predictor for the development of ocular GvHD. Overall, infrared meibography should be included in routine examination of patients undergoing aSCT and during follow-up.
眼部移植物抗宿主病（GvHD）中的睑板腺缺失被描述为导致干眼症和眼表严重损伤的一种机制。回顾性分析了86例眼部GvHD患者、10例异基因干细胞移植（aSCT）后无眼部GvHD的患者、32例aSCT前的患者以及30名健康对照者上睑睑板腺的红外图像，并使用两种分级方案进行评估。计算上睑板腺面积（uMGA）并将其与睑板总面积相关联。结果表明，与对照组相比，眼部GvHD患者以及aSCT前的患者睑板腺缺失显著增加（P在0.05至<0.001之间）。aSCT后无眼部GvHD的患者与对照组相比，uMGA无显著差异。本研究表明，GvHD患者的睑板腺缺失可能是一个多因素过程，在aSCT前也会发生，可能是由于基础疾病和/或继发于化疗或放疗。此外，必须解决睑板腺缺失是否可作为眼部GvHD发生的预测指标这一问题。总体而言，红外睑板腺照相术应纳入接受aSCT患者的常规检查及随访过程中。
