眼移植物抗宿主病伴神经营养性角膜病变患者的眼部疼痛。
Ocular pain in ocular graft-versus-host disease patients with neurotrophic keratopathy.
机构信息
Laboratory of Corneal Immunology, Transplantation and Regeneration, Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, 02114, USA.
Laboratory of Corneal Immunology, Transplantation and Regeneration, Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, 02114, USA.
出版信息
Ocul Surf. 2022 Oct;26:142-147. doi: 10.1016/j.jtos.2022.07.005. Epub 2022 Aug 7.
PURPOSE
Neurotrophic keratopathy (NK) is a degenerative disorder of the cornea characterized by decreased sensory innervation, epitheliopathy, and impaired epithelial healing. In this study, we assessed ocular pain and quality-of-life-related parameters in ocular graft-versus-host disease (oGVHD) patients with and without NK.
METHODS
We included 213 oGVHD patients in this retrospective study, including 29 patients with NK assessed by the Cochet-Bonnet esthesiometer. We evaluated their records for ocular pain assessment survey (OPAS) scores and clinical parameters, including corneal sensation, corneal fluorescein staining (CFS) score, Schirmer's test, tear break-up time (TBUT), and ocular surface disease index (OSDI) score.
RESULTS
oGVHD patients with NK had lower corneal sensation (3.4 ± 1.4 vs. 5.9 ± 0.3; p < 0.0001), higher CFS scores (6.4 ± 4.2 vs. 4.7 ± 4.0; p = 0.01), and lower TBUT scores (1.2 ± 2.1 vs. 2.2 ± 3.1; p = 0.08) compared to oGVHD patients without NK and additionally had significantly higher ocular pain intensity scores (OPAS 24-h average eye pain intensity: 2.0 ± 2.8 vs. 1.1 ± 1.9; p = 0.03). Patients with NK more commonly reported burning (0.2 ± 0.3 vs. 0.3 ± 0.4; p = 0.021) and sensitivity to light (0.2 ± 0.3 vs. 0.3 ± 0.4; p = 0.049) as compared to patients without NK.
CONCLUSION
Clinical signs of ocular surface disease are worse in oGVHD patients with NK compared to oGVHD patients without NK. These patients additionally experience higher intensity ocular pain and lower quality-of-life-related parameters.
目的
神经营养性角膜病变（NK）是一种以感觉神经支配减少、上皮病变和上皮愈合受损为特征的角膜退行性疾病。本研究评估了伴有和不伴有 NK 的眼移植物抗宿主病（oGVHD）患者的眼部疼痛和生活质量相关参数。
方法
本回顾性研究纳入了 213 例 oGVHD 患者，其中 29 例患者采用 Cochet-Bonnet 触觉计评估 NK。我们评估了他们的记录，包括眼部疼痛评估调查（OPAS）评分和临床参数，包括角膜感觉、角膜荧光素染色（CFS）评分、泪液分泌试验、泪膜破裂时间（TBUT）和眼表面疾病指数（OSDI）评分。
结果
与无 NK 的 oGVHD 患者相比，伴有 NK 的 oGVHD 患者的角膜感觉更低（3.4±1.4 对 5.9±0.3；p<0.0001），CFS 评分更高（6.4±4.2 对 4.7±4.0；p=0.01），TBUT 评分更低（1.2±2.1 对 2.2±3.1；p=0.08），且眼部疼痛强度评分显著更高（OPAS 24 小时平均眼痛强度：2.0±2.8 对 1.1±1.9；p=0.03）。与无 NK 的患者相比，NK 患者更常报告烧灼感（0.2±0.3 对 0.3±0.4；p=0.021）和对光敏感（0.2±0.3 对 0.3±0.4；p=0.049）。
结论
与无 NK 的 oGVHD 患者相比，伴有 NK 的 oGVHD 患者的眼表面疾病临床体征更差。这些患者还经历更高强度的眼部疼痛和更低的生活质量相关参数。
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