Purpose

Neurotrophic keratopathy (NK) is a degenerative disorder of the cornea characterized by decreased sensory innervation, epitheliopathy, and impaired epithelial healing. In this study, we assessed ocular pain and quality-of-life-related parameters in ocular graft-versus-host disease (oGVHD) patients with and without NK.

Methods

We included 213 oGVHD patients in this retrospective study, including 29 patients with NK assessed by the Cochet-Bonnet esthesiometer. We evaluated their records for ocular pain assessment survey (OPAS) scores and clinical parameters, including corneal sensation, corneal fluorescein staining (CFS) score, Schirmer's test, tear break-up time (TBUT), and ocular surface disease index (OSDI) score.

Results

oGVHD patients with NK had lower corneal sensation (3.4 ± 1.4 vs. 5.9 ± 0.3; p < 0.0001), higher CFS scores (6.4 ± 4.2 vs. 4.7 ± 4.0; p = 0.01), and lower TBUT scores (1.2 ± 2.1 vs. 2.2 ± 3.1; p = 0.08) compared to oGVHD patients without NK and additionally had significantly higher ocular pain intensity scores (OPAS 24-h average eye pain intensity: 2.0 ± 2.8 vs. 1.1 ± 1.9; p = 0.03). Patients with NK more commonly reported burning (0.2 ± 0.3 vs. 0.3 ± 0.4; p = 0.021) and sensitivity to light (0.2 ± 0.3 vs. 0.3 ± 0.4; p = 0.049) as compared to patients without NK.

Conclusion

Clinical signs of ocular surface disease are worse in oGVHD patients with NK compared to oGVHD patients without NK. These patients additionally experience higher intensity ocular pain and lower quality-of-life-related parameters.

中文翻译：

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伴有神经营养性角膜病变的眼移植物抗宿主病患者的眼痛

目的

神经营养性角膜病变 (NK) 是一种角膜退行性疾病，其特征是感觉神经支配减少、上皮病变和上皮愈合受损。在这项研究中，我们评估了伴有和不伴有 NK 的眼部移植物抗宿主病 (oGVHD) 患者的眼痛和生活质量相关参数。

方法

我们在这项回顾性研究中纳入了 213 名 oGVHD 患者，其中包括 29 名通过 Cochet-Bonnet 感觉仪评估的 NK 患者。我们评估了他们的眼痛评估调查 (OPAS) 评分和临床参数的记录，包括角膜感觉、角膜荧光素染色 (CFS) 评分、Schirmer 测试、泪膜破裂时间 (TBUT) 和眼表疾病指数 (OSDI) 评分.

结果

oGVHD 患者的 NK 角膜感觉较低（3.4 ± 1.4 对 5.9 ± 0.3；p < 0.0001），CFS 评分较高（6.4 ± 4.2 对 4.7 ± 4.0；p = 0.01），TBUT 评分较低（1.2 ± 2.1 对. 2.2 ± 3.1; p = 0.08) 与没有 NK 的 oGVHD 患者相比，另外还有明显更高的眼痛强度评分（OPAS 24 小时平均眼痛强度：2.0 ± 2.8 对 1.1 ± 1.9；p = 0.03）。与没有 NK 的患者相比，NK 患者更常报告灼痛（0.2 ± 0.3 对 0.3 ± 0.4；p = 0.021）和对光的敏感性（0.2 ± 0.3 对 0.3 ± 0.4；p = 0.049）。

结论

与没有 NK 的 oGVHD 患者相比，有 NK 的 oGVHD 患者眼表疾病的临床症状更严重。这些患者还经历了更高强度的眼痛和更低的生活质量相关参数。