造血干细胞移植术后的眼部观察

Ocular manifestations after hematopoietic stem cell transplantation

目的 观察造血干细胞术后移植物抗宿主病 (GVHD)及预处理措施对眼部的影响。方法 对 3 5例行造血干细胞移植患者的眼科检查进行回顾性分析。结果 3 5例中慢性GVHD 14例 ,占异基因造血干细胞移植的 70 %。其中 8例合并有干眼 ,占GVHD患者的 5 7 14 % ;6例睑板腺功能障碍并伴有干眼。眼部其他并发症有结膜瘢痕、睑球粘连、角膜溃疡、白内障、急性结膜炎、眼底出血或结膜出血。自体造血干细胞移植不出现移植物抗宿主病及干眼。结论 干眼是异基因造血干细胞移植术后的主要眼部并发症 ,仅见于发生GVHD的患者。异基因造血干细胞移植的眼部并发症明显高于自体干细胞移植。

ObjectiveTo investigate the effect of graft-versus-host disease(GVHD) and preparative regimens on eyes after hematopoietic stem cell transplantation(SCT).MethodsThirty-five eyes with leukemia underwent allogeneic or autologous SCT.The ocular surface were examined by slit-lamp biomicroscope.The ocular examination also included evaluation of tear break up time,Schirmer tests with and without nasal stimulation and Meibomian gland secretion.ResultsOf the 35 patients,14 developed chronic GVHD with the incidence 70% in allogeneic SCT,but no patient received autogeneic SCT developed GVHD.The ocular complication included 8 cases of dry eye.All patients suffering dry eye were companied with GVHD.The incidence of dry eye in GVHD was 57.14%.Six patients associated with dry eye presented with Meibomian gland dysfunction.The other ocular complications were conjunctival cicatrization,symblepharon,corneal ulcer,cataract,acute conjunctivitis and fundus or subconjunctival hemorrhage.ConclusionDry eye is the main ocular complication after allogeneic hematopoietic SCT,and it only occur in the patients of GVHD.The incidence of ocular complication in allogeneic SCT is higher than that of autologous SCT.