Comparable meibomian gland changes in patients with and without ocular graft-versus-host disease after hematopoietic stem cell transplantation

Wenxin Zhao; Jing Yang; Yinglin Liao; Hubert Yuenhei Lao; Quanbin Huang; Ling Jin; Jing Sun; Fen Huang; Lingyi Liang

doi:10.1016/j.jtos.2022.04.002

Comparable meibomian gland changes in patients with and without ocular graft-versus-host disease after hematopoietic stem cell transplantation

Ocul Surf. 2022 Jul:25:1-7. doi: 10.1016/j.jtos.2022.04.002. Epub 2022 Apr 5.

Authors

Wenxin Zhao¹, Jing Yang¹, Yinglin Liao¹, Hubert Yuenhei Lao¹, Quanbin Huang¹, Ling Jin¹, Jing Sun², Fen Huang³, Lingyi Liang⁴

Affiliations

¹ State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
² Department of Hematology, Nanfang Hospital, Southern Medical University, No. 1838, North Guangzhou Avenue, Guangzhou, Guangdong, 510515, China.
³ Department of Hematology, Nanfang Hospital, Southern Medical University, No. 1838, North Guangzhou Avenue, Guangzhou, Guangdong, 510515, China. Electronic address: 13826204917@163.com.
⁴ State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China. Electronic address: lianglingyi@gzzoc.com.

PMID: 35395386
DOI: 10.1016/j.jtos.2022.04.002

Abstract

Purpose: To compare the presentation and severity of meibomian gland dysfunction (MGD) in patients with and without chronic ocular graft-versus-host disease (coGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).

Methods: This prospective cross-sectional study included 79 patients (47 with coGVHD and 32 without) after allo-HSCT. All participants completed ocular surface disease index questionnaire, and received slit lamp, ocular surface interferometer, meibography and confocal microscopy examination. The prevalence and severity of MGD were compared between two groups and related factors were analyzed. Main outcome measures were lipid layer thickness (LLT) and meiboscore.

Results: Similarly high prevalence of MGD was detected in coGVHD and non-coGVHD groups (87.2% vs 84.4%, P = 0.977). Among those with MGD, although patients without coGVHD had longer noninvasive break-up time [5.54 (2.87, 9.37) vs 2.29 (0.00, 3.82) s, P < 0.001], patients in two groups presented similarly decreased LLT (53.5 ± 22.3 vs 47.1 ± 25.2 nm, P = 0.286), increased meiboscore (2.7 ± 1.5 vs 3.5 ± 1.8, P = 0.060) and enlarged acinar unit area (1647.7 ± 942.9 vs 1808.8 ± 1211.5 μm², P = 0.592). Meibomian gland inflammation and fibrosis were observed in both groups, but more predominant in coGVHD group. Results were consistent when patients within a comparable post-HSCT time interval were compared. Regression analysis revealed neither LLT nor meiboscore was associated with coGVHD severity. LLT was positively correlated with systemic immunosuppressant use (β = 12.0, P = 0.044), while meiboscore was positively correlated with lymphoma (β = 1.78, P = 0.040) and matched unrelated donor (β = 1.59,P = 0.008).

Conclusions: MGD was common and evident in patients after allo-HSCT. MGD is not different between coGVHD and non-coGVHD patients except more inflammation and fibrosis in the former.

Keywords: Chronic ocular graft-versus-host disease; Lipid layer thickness; Meibomian gland dysfunction; Meiboscore.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cross-Sectional Studies
Dry Eye Syndromes* / diagnosis
Fibrosis
Graft vs Host Disease* / diagnosis
Graft vs Host Disease* / epidemiology
Graft vs Host Disease* / metabolism
Hematopoietic Stem Cell Transplantation* / adverse effects
Humans
Inflammation / metabolism
Meibomian Gland Dysfunction* / diagnosis
Meibomian Gland Dysfunction* / epidemiology
Meibomian Gland Dysfunction* / etiology
Meibomian Glands / metabolism
Prospective Studies
Tears / metabolism