Kosrirukvongs P, Chirapapaisan N, Visuthisakchai S, Issaragrisil S, Gonggetyai V.
J Med Assoc Thai. 2008 Nov;91(11):1739-47.
OBJECTIVE: To study the incidence of dry eye in Sjögren-like syndrome, graft-versus-host disease (GVHD) in hematological patients undergoing bone marrow transplantation (BMT).
MATERIAL AND METHOD: Prospective, cross-sectional study in twenty-six patients that were planned for BMT (group I). Twenty-nine patients undergoing BMT before study were classified as group II no GVHD (9), and group III with GVHD (20). Thirty-two normal subjects were controls. All subjects were examined by slit lamp biomicroscopy and had their tear samples analyzed about tear osmolarity. They were also evaluated for aqueous tear production by phenol red thread test, Schirmer test without anesthesia, tear film stability by tear break-up time (TBUT), and rose bengal staining 2 weeks before BMT (for group I) as well as 6 weeks, 3 months, and 6 months after BMT. The patients with GVHD were followed up 1 month later. Main outcome measures were amount of tear production, tear film stability, and dry eye symptoms.
RESULTS: Average aqueous tear production in group III was less than control and group II (p < 0.001). Mean TBUT in group III was faster than control (p < 0.001) and group I before BMT (p = 0.001). Mean score of rose bengal staining in group III was more than control and group I before BMT (p < 0.001). Keratoconjunctivitis sicca and red eye developed in 27.5%, and 20% of group III, with incidence of dry eye by Schirmer test without anesthesia (67.5%). This compares with group II having incidence of dry eye of 16.7%. However, 42.3% of group I before BMT had dry eye compared with 9.4% in the controls (p < 0.001).
CONCLUSION: Trend of dry eye in patients with BMT and GVHD were higher than no-GVHD group. Doctors should be aware of ocular symptoms and signs of dry eye in patients with BMT and follow-up for proper management.
2 comments:
I had a myeloablative allogeneic matched related donor stem cell transplant in October 2007. In March 2008 I developed GVHd and dry eyes. Restassis did nothing. I now use autologous plasma eye drops and I get amazing relief. However I still find that my site and blurriness are bad at the end of the day.
I had ALL and recieved a matched unrelated stem cell transplant. I lost all tear production due to GVHD and tried many treatments NONE helped..UNTIL I went to the Boston Foundation for Sight and recieved the Boston Ocular Surface Prosthesis...they saved me!!!!
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