Cornea · 2024
Concurrent Limbal Stem Cell Deficiency and Mild Neurotrophic Keratopathy in Graft-Vs-Host Disease.
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Yavuz Saricay Leyla, Surico Pier Luigi, Tandias Rachel, Jurkunas Ula V, Dana Reza
Аннотация
PURPOSE: The purpose of this study was to delineate the concurrence of limbal stem cell deficiency (LSCD) and neurotrophic keratopathy in patients with ocular graft-vs-host disease (oGVHD).
METHODS: Medical records of patients with oGVHD were reviewed. Parameters collected included corneal sensitivity measured by using a noncontact esthesiometer, corneal fluorescein staining score (National Eye Institute grading scale), tear volume (Schirmer I test), and subbasal nerve density and limbal structure assessed by in vivo confocal microscopy.
RESULTS: Twenty-eight patients (mean age: 60.8 ± 10.4 years) with oGVHD were included; 50% (n = 14) had partial LSCD (P-LSCD), and 32% (n = 9) had complete LSCD (C-LSCD). Patients with C-LSCD showed significantly reduced total nerve density and branch nerve density compared with those with P-LSCD ( P < 0.02, P < 0.04) and no LSCD ( P < 0.01, P = 0.02). Dendritic cell density was significantly higher in the C-LSCD group compared with the no LSCD group ( P < 0.05). Corneal sensitivity was significantly reduced in patients with C-LSCD compared with those with P-LSCD ( P = 0.01) and no LSCD ( P < 0.02). Patients with C-LCSD had higher corneal fluorescein staining scores than patients with P-LSCD ( P < 0.01) and no LSCD ( P = 0.02).
CONCLUSIONS: This study highlights a significant concurrence of LSCD and neurotrophic keratopathy in patients with oGVHD, underscoring the link between inflammation, neurodegeneration, and loss of stem cell function.
METHODS: Medical records of patients with oGVHD were reviewed. Parameters collected included corneal sensitivity measured by using a noncontact esthesiometer, corneal fluorescein staining score (National Eye Institute grading scale), tear volume (Schirmer I test), and subbasal nerve density and limbal structure assessed by in vivo confocal microscopy.
RESULTS: Twenty-eight patients (mean age: 60.8 ± 10.4 years) with oGVHD were included; 50% (n = 14) had partial LSCD (P-LSCD), and 32% (n = 9) had complete LSCD (C-LSCD). Patients with C-LSCD showed significantly reduced total nerve density and branch nerve density compared with those with P-LSCD ( P < 0.02, P < 0.04) and no LSCD ( P < 0.01, P = 0.02). Dendritic cell density was significantly higher in the C-LSCD group compared with the no LSCD group ( P < 0.05). Corneal sensitivity was significantly reduced in patients with C-LSCD compared with those with P-LSCD ( P = 0.01) and no LSCD ( P < 0.02). Patients with C-LCSD had higher corneal fluorescein staining scores than patients with P-LSCD ( P < 0.01) and no LSCD ( P = 0.02).
CONCLUSIONS: This study highlights a significant concurrence of LSCD and neurotrophic keratopathy in patients with oGVHD, underscoring the link between inflammation, neurodegeneration, and loss of stem cell function.