Purpose: To characterize anatomical and functional changes in the ocular surface after hematopoietic stem cell transplantation.
Methods: Three groups of patients were included in the study. Group 1: patients who had undergone allogeneic hematopoietic stem cell transplantation (HSCT) (n = 26). Group 2: patients who developed chronic graft versus host disease (GvHD) after HSCT (n = 14). Group 3: healthy subjects (n = 20). A complete ophthalmological examination was undertaken in all subjects, including Schirmer's test, TBUT (break-up-time) test, Oxford scale, OSDI test, corneal tomography, and conjunctival CD8+ lymphocyte detection.
Results: In Branch 1 (comparative analysis before and after HSCT in Group 1), statistically significant differences were found in the following variables: best-corrected visual acuity (BCVA) OD (P = 0.08), OSDI test (P = 0.003), TBUT OU (OD P= 0, OS P= 0.0003), Oxford test OU (OD P= 0.01, OS P= 0.0049), and CD8+ lymphocytes OU (OD P= 0.003, OS P= 0.01). In Branch 2 (comparative analysis between Group 2 and 3), the variables with statistically significant differences (P < 0.001) in OU were: BCVA, OSDI test, Schirmer's test OU, TBUT test, Oxford test, and CD8+ lymphocytes. Finally, in Branch 3 (comparative analysis between Group 1 after HSCT and Group 2), statistically significant differences (P < 0.001) were found OU: in OSDI test, Schirmer's test, and Oxford test OU; and with P < 0.005 in TBUT test OU.
Conclusion: In our study, statistically significant changes were observed in the OSDI test, TBUT test, Oxford Scale, and the detection of CD8+ lymphocytes in patients who underwent HSCT. Differences were more significant in those patients who had developed GvHD after HSCT compared to those without GvHD.
Keywords: Allogeneic stem cell transplantation; OSDI test; Schirmer's test; conjunctival CD8+ lymphocyte detection; graft-versus-host disease.