Corneal Subbasal Nerve Alterations and Tear Cytokine Associations in Ocular Chronic Graft-versus-Host Disease

Yinghan ZhaoJiao MaZhan ShenBohao HuRongmei PengShuwan LiuChendi LiJing Hong^*

• Department of Ophthalmology, Peking University Third Hospital, Beijing, China

Objective: To determine the corneal subbasal nerve parameters associated with ocular chronic graft-versus-host disease (cGVHD) and their relationships with tear cytokine levels. Methods: 26 ocular cGVHD patients, 8 non-GVHD patients and 20 dry eye disease patients were recruited. The corneal subbasal nerve parameters were detected using in vivo confocal microscopy. The density and tortuosity scale of the corneal nerve were examined. Clinical characteristics, ocular surface parameters and tear cytokine levels, including NGF-β, G-CSF, GM-CSF, M-CSF, FGF1, FGF2, Fas-L, PDGF-CC and CD137, were also analyzed. Results: Compared with DED patients, GVHD patients have significantly greater corneal subbasal nerve tortuosity and lower density; however, no differences were noted compared with non-GVHD patients. NGF-β, G-CSF, GM-CSF, M-CSF, FGF1, FGF2, Fas-L and CD137 levels were evaluated in the tears of GVHD patients compared with those of DED patients. M-CSF, FGF1 and Fas-L were present at higher concentrations in GVHD patients than in non-GVHD patients. The PDGF-CC concentration was lower in the GVHD group compared with the non-GVHD group. M-CSF, GM-CSF, FGF1, FGF2, Fas-L, CD137 and PDGF-CC levels are associated with the density of the corneal subbasal nerve. M-CSF, GM-CSF, FGF1, FGF2, Fas-L and CD137 levels correlated with the tortuosity of the subbasal nerve. Conclusions: In ocular cGVHD patients, the corneal subbasal nerve has a lower density and greater tortuosity but is similar to that in non-GVHD patients. IVCM findings of the corneal subbasal nerve are likely associated with tear cytokine changes.