| Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Korea(1)
Department of Ophthalmology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea(2) |
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Purpose : To evaluate morphological changes in meibomian glands (MGs) over 1 year in patients diagnosed with chronic ocular graft-versus-host disease (GVHD), and to determine the association between MG loss and ocular surface parameters in such patients.
Methods : This retrospective, observational study included 37 patients diagnosed with ocular GVHD who were followed-up for at least 1 year in the ophthalmology department. All patients received treatment during the follow-up period. The Ocular Surface Disease Index (OSDI) score, tear breakup time (TBUT), corneal staining score, lid margin score, Schirmer test I value, and noncontact infrared meibography findings were evaluated at baseline and after 1 year of follow-up for ocular GVHD. Both eyes were included in the analyses.
Results : OSDI (p=0.0391), corneal fluorescein scores (p=0.0352 and 0.0181 for the right and left eyes, respectively), and upper and lower eyelid meiboscores (right eye: p=0.0039 and 0.0156, respectively: left eye: p=0.0273 and 0.0156, respectively) were significantly higher at 1 year than at baseline. Infrared meibography showed MG loss in 18.9% of eyes, improvement in 5.4% of eyes, and no changes in 75.7% of eyes, respectively. The Schirmer value for the right eye negatively correlated with the upper eyelid meiboscore at 1 year (p=0.0103, r=−0.46), whereas the corneal fluorescein score for the left eye positively correlated with both upper and lower eyelid meiboscores at 1 year (p=0.0368, r=0.40; p=0.0387, r=0.39, respectively).
Conclusion : Rapid and aggressive MG destruction may occur in patients with ocular GVHD. Continuous treatment must be administered, despite the absence of symptoms of ocular GVHD.
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