造血干细胞移植患者红外睑板腺成像的纵向分析。

Longitudinal Analysis of Infrared Meibography in Patients Undergoing Hematopoietic Stem Cell Transplantation.

机构信息

Ophthalmology Unit, S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy.

Haematology Institute "L.A. Seragnoli," S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy; and.

出版信息

Cornea. 2020 Jul;39(7):812-817. doi: 10.1097/ICO.0000000000002271.

DOI:10.1097/ICO.0000000000002271

PMID:31985519

Abstract

PURPOSE

To evaluate meibomian gland (MG) changes in patients undergoing hematopoietic stem cell transplantation (HSCT) by infrared meibography and to further investigate possible correlations with hematological characteristics.

METHODS

Thirty-three patients were included: infrared meibography of the lower eyelid, Schirmer test, tear break-up time, ocular surface staining, and Ocular Surface Disease Index questionnaire were conducted before (V0) and 4 months after HSCT (V1). A paired samples t test was used to compare parameters before and after HSCT. A mixed analysis of variance was used to assess the effect of hematological characteristics on changes of MG loss (MGL) after HSCT.

RESULTS

MGL and corneal staining significantly increased after HSCT (respectively, from 24.3% ± 10.1% to 32.2 ± 15.0 and from 1.2 ± 1.5 to 2.0 ± 1.7; always P < 0.011), whereas tear break-up time significantly decreased (from 6.6 ± 4.2 seconds to 3.2 ± 2.2; P < 0.001). At V1, 19 patients (57.6%) belonged to ocular graft-versus-host disease severity grade 0, 8 (24.2%) to grade I, and 6 (18.2%) to grade II. The percentage of MGL at V0 and the increase of MGL from V0 to V1 did not differ between patients who developed ocular graft-versus-host disease and those who did not (always P > 0.05). At V1, MGs' quality reduced in 16 patients (48.5%), remained unchanged in 14 (42.4%), and improved in 3 (9.1%). The increase of MGL after HSCT was higher in patients receiving myeloablative conditioning regimen (P = 0.005).

CONCLUSIONS

MG function, loss, and quality significantly worsened after HSCT. Myeloablative conditioning regimen was associated with higher MGL.

摘要

目的

通过红外睑板腺成像评估造血干细胞移植（HSCT）患者的睑板腺（MG）变化，并进一步研究与血液学特征的可能相关性。

方法

共纳入 33 例患者：在下眼睑进行红外睑板腺成像、泪液分泌试验、泪膜破裂时间、眼表面染色和眼表面疾病指数问卷，分别在 HSCT 前（V0）和 4 个月后（V1）进行。采用配对样本 t 检验比较 HSCT 前后各参数。采用混合方差分析评估血液学特征对 HSCT 后 MG 丢失（MGL）变化的影响。

结果

HSCT 后 MGL 和角膜染色显著增加（分别从 24.3%±10.1%增加至 32.2%±15.0%和从 1.2±1.5 增加至 2.0±1.7，均 P＜0.011），而泪膜破裂时间显著减少（从 6.6±4.2 秒减少至 3.2±2.2，P＜0.001）。在 V1 时，19 例患者（57.6%）属于眼部移植物抗宿主病严重程度 0 级，8 例（24.2%）为 1 级，6 例（18.2%）为 2 级。发生眼部移植物抗宿主病和未发生眼部移植物抗宿主病患者的 V0 时 MGL 百分比和 V0 至 V1 的 MGL 增加无差异（均 P＞0.05）。在 V1 时，16 例患者（48.5%）MG 质量下降，14 例患者（42.4%）质量不变，3 例患者（9.1%）质量改善。HSCT 后 MGL 增加与接受骨髓清除性预处理方案有关（P=0.005）。