Conjunctival surface damage distribution in keratoconjunctivitis sicca. An impression cytology study.

Area of Science:

• Ophthalmology
• Cell Biology
• Dry Eye Disease Research

Background:

• Keratoconjunctivitis sicca (dry eye disease) affects the ocular surface.
• Tear film instability is a key factor in dry eye.
• The role of tear evaporation in dry eye pathogenesis requires further investigation.

Purpose of the Study:

• To investigate ocular surface changes in patients with keratoconjunctivitis sicca using impression cytology.
• To differentiate cellular changes based on Schirmer I test results.
• To explore the pathogenetic role of tear evaporation in dry eye.

Main Methods:

• Impression cytology was performed on 32 eyes diagnosed with keratoconjunctivitis sicca.
• Eyes were categorized into two groups based on Schirmer I test results (<5.5 mm/5 min and >5.5 mm/5 min).
• Goblet cell density and cytoplasm/nucleus ratio were analyzed on the bulbar conjunctiva.

Main Results:

• Eyes with Schirmer test <5.5 mm/5 min showed reduced goblet cells and increased cytoplasm/nucleus ratio across the bulbar conjunctiva.
• Eyes with Schirmer test >5.5 mm/5 min exhibited similar changes, but localized to the interpalpebral bulbar conjunctiva.
• The ocular surface protected by eyelids appeared relatively normal in the second group.

Conclusions:

• Tear evaporation plays a significant role in the pathogenesis of dry eye disease.
• Tear film instability can lead to ocular surface cellular alterations even with normal tear production.
• These findings highlight the importance of addressing tear evaporation in managing dry eye.