Risk factors associated with severity of dry eye syndrome in ocular graft-versus-host disease

• Published in: Canadian journal of ophthalmology 2020-10, Vol.55 (5), p.366-372
• Main Authors: Wang, Jay Ching Chieh, Mustafa, Majd, Teichman, Joshua C., O’Donnell, Heather, Broady, Raewyn, Yeung, Sonia N.
• Format: Article
• Language: English
• ISSN: 0008-4182; 1715-3360
• DOI: 10.1016/j.jcjo.2020.04.013

The aim of this study was to identify risk factors for the development of severe dry eye syndrome (DES) in patients with ocular graft-versus-host disease (oGVHD). Retrospective Chart Review. Patients undergoing allogeneic hematopoietic stem cell transplantation at the British Columbia Cancer Agency between 2011 and 2013. A retrospective chart review of post-transplant patients with oGVHD DES followed at the British Columbia Cancer Agency Bone Marrow Transplant Unit was performed. Patient and donor data were collected. Descriptive and inferential statistics were carried out. Linear, logistic, and ordered logistic regression analyses were carried out. DES severity was graded using the National Institutes of Health criteria. Of the 78 patients studied, 39 (50%) were male. The median age and Schirmer score were 56 years (range 24–71 years) and 14 mm (range 0–25 mm), respectively. A lower Schirmer score (p = 0.0001), severe overall chronic graft-versus-host disease (GVHD) (p < 0.0001), and lung involvement (p = 0.04) were associated with worsening oGVHD DES. Ordered logistic regression analysis revealed characteristics predictive of oGVHD severity. Fourteen patients (17.95%) had severe DES. Compared with those with nonsevere DES, this group was more likely to be male (p = 0.02) and have a lower Schirmer score (p = 0.01), significantly worse overall chronic GVHD (p = 0.002), as well as lung (p = 0.02) and gastrointestinal tract (p = 0.02) involvement. Logistic regression analysis revealed characteristics predictive of severe oGVHD DES. This study identified potential risk factors associated with the development of severe DES in patients with oGVHD. Notre étude avait pour objectif de définir les facteurs de risque d'apparition d'une sécheresse oculaire (SO) grave chez des patients qui présentaient une maladie du greffon contre l'hôte (GVHD, pour graft-versus-host disease) oculaire. Examen rétrospectif de dossiers médicaux. Patients ayant subi une allogreffe de cellules souches hématopoïétiques à la British Columbia Cancer Agency entre 2011 et 2013. On a procédé à un examen rétrospectif des dossiers médicaux de patients qui ont subi une greffe et qui présentaient une SO au décours d'une GVHD oculaire à l'unité de greffe de moelle osseuse de la British Columbia Cancer Agency. Ont été recensées les données sur les patients et les donneurs, lesquelles ont servi à l’établissement de statistiques descriptives et déductives. Des analyses de régression linéaire, logistiq