Anterior Segment Optical Coherence Tomography Imaging of the Lacrimal Gland in Patients With Chronic Ocular Graft-Vs-Host Disease

Abstract

Purpose: The purpose of this study was to explore the image characteristics of the palpebral lobe of the lacrimal gland in patients with chronic ocular graft-vs-host disease (coGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) using anterior segment optical coherence tomography (AS-OCT). Methods: This comparative cross-sectional study included 32 patients with coGVHD, 21 patients with severe aqueous tear deficiency dry eye, and 20 healthy control subjects. All subjects underwent an AS-OCT examination on the palpebral lobe of the lacrimal gland. The main outcomes are the number of visible gland lobules, ducts, and blood vessels and the proportions of mille crêpe–like structures in the AS-OCT images. Results: Compared with the other 2 groups, patients with coGVHD had significantly more blood vessels and slightly less visible lobules and ducts (all P <0.05) in the palpebral lacrimal gland. Mille crêpe–like structures were observed only in the coGVHD group. Number of blood vessels was positively correlated with time after allo-HSCT (β: 0.14, 95% confidence interval [CI], 0.01–0.26). Mille crêpe–like structure was positively correlated with coGVHD severity (odds ratio: 9.07, 95% CI, 1.75–16.38) and time after allo-HSCT (odds ratio: 0.13, 95% CI, 0.03–0.23). Conclusions: We reported the AS-OCT characteristics of the palpebral lacrimal gland in coGVHD and found an increased number of blood vessels and mille crêpe–like structures. AS-OCT has the potential in the disease monitoring of coGVHD.