Individualized comprehensive medication for chronic graft-versus-host disease related severe dry eye disease / 眼科新进展

ABSTRACT

Objective To observe the clinical effects of individualized compre hensive treatment on dry eye disease secondary to chronic graft-versus-host disease.Methods A retrospective analysis was conducted on 19 patients (38 eyes) with dry eye disease associated with chronic graft-versus-host disease from March 2013 to November 2016 after treatment of hematopoietic stem cell transplantation,and the individualized comprehensive treatment including artificial tears,deproteinized calf blood extract eye gel,fibroblast growth factor eye gel and 1 g · L-1 fluorometholone eye drops were performed according to the severity of dry eye disease.Then slit lamp examination,the score on symptoms of dry eye,corneal fluorescein staining,tear break-up time (BUT) assay and Schirmer I test (SIT) were performed,and visual acuity was examined before and after treatment.Then,the changes of symptoms and signs of dry eye were observed completely before treatment and 2 months after treatment.Results The scores on partial symptoms of dry eye,including sensations of dryness,foreign mat ter,burning,pain,ocular hyperemia before and after treatment were 2.72 + 0.78 vs.1.68 + 0.82,2.58 + 0.89 vs.1.62 + 0.72,2.46 + 0.64 vs.1.57 + 0.59,2.27 + 0.54 vs.1.44 + 0.62,2.54 +0.66 vs.2.09 +0.58 respectively,presenting obviously improvement in these sensa tions (all P ＜0.05),while postoperative asthenopia and photophobia were slightly ameliorated,without statistical significance (P ＞ 0.05).Furthermore,visual acuity improved after treatment,and the difference was statistically siguificant;and there was significant difference in the score of corneal fluorescein staining between before treatment (8.6 + 2.4) to after treatment (2.2 + 1.6) (all P ＜0.05),but there was no significant difference in the score of BUT and SIT before and after treatment (all P ＞ 0.05).Conclusion The individual comprehensive medication can improve the subjective symptoms and signs of dry eye disease secondary to chronic graft-versus-host disease after hematopoi etic stem cell transplantation,and more importantly,ameliorate visual acuity.