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ORIGINAL RESEARCH article

Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders: Autoinflammatory Disorders
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1490390
This article is part of the Research Topic Autoinflammatory novelties: from pathogenic mechanisms to clinical and therapeutic implications View all articles

Application of lacrimal gland ultrasonography in the evaluation of chronic ocular graft-versus-host-disease

Provisionally accepted
Mingxia Zhong Mingxia Zhong 1,2*Siyuan Liu Siyuan Liu 1,2Jinghan Luo Jinghan Luo 1Qin Zhang Qin Zhang 1Zhou Yang Zhou Yang 3Shanshan Zhang Shanshan Zhang 1
  • 1 Peking University People's Hospital, Beijing, China
  • 2 Peking University, Beijing, Beijing Municipality, China
  • 3 School of Public Health, Health Science Centre, Peking University, Beijing, Beijing Municipality, China

The final, formatted version of the article will be published soon.

    Objective: To investigate the effectiveness of lacrimal gland ultrasonography in the assessment of chronic ocular graft-versus-host-disease(oGVHD) after allogeneic hematopoietic stem cell transplantation(allo-HSCT) and to establish the correlation between the ocular surface and ultrasonographic results. Method: The cross-sectional study included 57 participants aged 18 and older, who were at least 100 days after allo-HSCT. The study was conducted at the oGVHD clinic of Peking University People's Hospital between March to June 2023. Patients were categorized into groups according to the International Chronic oGVHD (ICCGVHD) consensus group diagnostic criteria or the 2005 National Institutes of Health (NIH) classification criteria for Chronic GVHD. Demographics and transplantation-related information were collected for all participants, including age, gender, donor-recipient HLA matching, donor-recipient ABO matching, donor-recipient gender combination and duration after allo-HSCT. The disease activity of oGVHD and the severity of ocular surface involvement were assessed using various parameters such as Ocular Surface Disease Index (OSDI), Schirmer test, tear film break-up time (BUT), tear meniscus height, corneal/ conjunctival staining and meibomian gland dropout. Lacrimal gland structures were assessed by B-mode and Doppler ultrasonography to measure parameters such as the long diameter, thick diameter, homogeneity and parenchymal vascularization. Statistical analyses were performed to determine differences in ocular surface conditions and lacrimal gland ultrasonographic parameters between groups as well as to determine the correlation between ocular surface condition and lacrimal gland ultrasonographic findings. Conclusion: The ocular surface condition in oGVHD patients is worse than that observed in non-GVHD patients. The main manifestations include keratoconjunctival injury and a reduction in tear secretion and tear film stability. These effects appear to be a common result of chemoradiotherapy-induced inflammation and rejection-associated responses. There were no significant differences in the morphology of lacrimal glands as revealed by ultrasonography. This suggests that ocular rejection may not be the primary cause of lacrimal gland changes in oGVHD patients. While ultrasonography can provide insight into tear secretion, its efficacy in diagnosing oGVHD appears limited

    Keywords: Ocular graft-versus-host-disease, B-mode ultrasonography, lacrimal gland, Dry eye disease, Ocular surface status

    Received: 03 Sep 2024; Accepted: 13 Jan 2025.

    Copyright: © 2025 Zhong, Liu, Luo, Zhang, Yang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Mingxia Zhong, Peking University People's Hospital, Beijing, China

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