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KMID : 0360220080490050891
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Journal of the Korean Ophthalmological Society
2008 Volume.49 No. 5 p.891 ~ p.896
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The Effect of Systemic Steroid Therapy on Dry Eye in Hematopoietic Stem Cell Transplantated Patients
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Hwang Hyung-Bin
Jun Eun-Jung
Chung Sung-Kun
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Abstract
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Purpose:To evaluate the effects of systemic steroid therapy on the development of dry eye syndrome (DES) in graft-versus-host disease (GVHD) resulting from hematopoietic stem cell transplantation (HSCT) in hematologic malignancy (HM) patients.
Methods:We analyzed 108 HSCT patients. We measured tear film break?up time (BUT) and basal tear secretion, and checked for corneal lesions. BUT under 10 seconds and basal tear secretion under 10 mm gave a diagnosis of DES. Significant corneal lesions were also described in this gorup. We compared the clinical aspect and frequency of dry eye according to GVHD and also compared clinical aspects of dry eye in GVHD patients before and after systemic steroid therapy.
Results: Fifty-six patients (51.9%) developed GVHD, including 51 patients (91.1%) in the GVHD group and 31 patients (59.6%) in the non-GVHD group. The frequency of DES was statistically significant in the GVHD group (p<0.05). BUT and basal tear secretions were 4.08±1.76 sec and 6.05±2.57 mm in the GVHD group and 5.37±1.83 sec and 7.08±1.54 mm. There were 32 peoples (57.1%) with corneal lesions in the GVHD group and 13 peoples (25.0%) in the non-GVHD group. Based on these results, DES was statistically significant in the GVHD group. In the GVHD group, BUT and basal tear secretion levels were 4.08±1.76 sec and 6.05±2.57 mm before systemic steroid therapy and 5.20±2.91 sec and 6.73±1.80 mm after the therapy. The difference was statistically significant (p<0.05), so we concluded that systemic steroid therapy relieved DES. Before steroid therapy, 32 peoples (57.1%) had corneal lesions, and this number decreased to 25 peoples (44.6%) after steroid therapy. The difference was not statistically significant, but we presumed that steroid therapy improved the corneal lesions (p>0.05).
Conclusions:The severity and frequency of DES were high in the GVHD group. At the same time, systemic steroid therapy could relieve DES in GVHD patients. Therefore, proper medical treatment and ocular examinations should be performed for HSCT patients.
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KEYWORD
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Dry eye syndrome, Graft-versus-host disease, Systemic steroid therapy
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