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.

中文翻译：

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造血干细胞移植后有和没有眼移植物抗宿主病的患者的睑板腺变化相似

目的

比较异基因造血干细胞移植 (allo-HSCT) 后患有和未患有慢性眼移植物抗宿主病 (coGVHD) 的患者睑板腺功能障碍 (MGD) 的表现和严重程度。

方法

这项前瞻性横断面研究包括在 allo-HSCT 后的 79 名患者（47 名患有 coGVHD，32 名没有）。所有参与者均完成眼表疾病指数问卷调查，并接受裂隙灯、眼表干涉仪、眼表成像和共聚焦显微镜检查。比较两组MGD的患病率和严重程度，并分析相关因素。主要结果测量是脂质层厚度（LLT）和meiboscore。

结果

在 coGVHD 和非 coGVHD 组中检测到类似的高 MGD 患病率（87.2% 对 84.4%，P  = 0.977）。在 MGD 患者中，尽管没有 coGVHD 的患者无创性破裂时间较长 [5.54 (2.87, 9.37) vs 2.29 (0.00, 3.82) s，P  < 0.001]，但两组患者的 LLT 均相似降低（53.5 ± 22.3 vs 47.1 ± 25.2 nm, P  = 0.286)，增加的 meiboscore (2.7 ± 1.5 vs 3.5 ± 1.8, P  = 0.060) 和扩大的腺泡单位面积 (1647.7 ± 942.9 vs 1808.8 ± 1211.5 μm ² , P = 0.592）。两组均观察到睑板腺炎症和纤维化，但在coGVHD组中更为突出。当比较可比较的 HSCT 后时间间隔内的患者时，结果是一致的。回归分析显示 LLT 和 meiboscore 均与 coGVHD 严重程度无关。LLT 与全身免疫抑制剂的使用呈正相关（β = 12.0，P  = 0.044），而 meiboscore 与淋巴瘤（β = 1.78，P  = 0.040）和匹配的无关供体（β = 1.59，P  = 0.008）呈正相关。

结论

在 allo-HSCT 后，MGD 在患者中常见且明显。除了前者更多的炎症和纤维化外，MGD在coGVHD和非coGVHD患者之间没有区别。