Conjunctival Histopathological Changes and Clinical Tear Film in Children with Atopic Dermatitis

Evaluation of changes in the ocular surfaces in children with a diagnosis of atopic dermatitis (AD).

Thirty-six children with a diagnosis of AD (Eye-AD group) and 40 healthy subjects (Eye-HS group) were enrolled in this prospective case-control study. Tear film break-up time (T-BUT), Schirmer tear test (STT), conjunctival impression cytology (CIC), tear meniscus height (TMH), tear meniscus area (TMA), and ocular surface disease index (OSDI) were measured.

The participants were similar in terms of demographic characteristics, such as mean age and gender (p > 0.05). The mean T-BUT was 9.3 ± 2.22 s (5 - 16) in the Eye-AD group and 11.83 ± 2.03 s (7 - 16) in the Eye-HS group. The mean STT was 11.12 ± 3.28 mm (5 - 21) in the Eye-AD group and 15.44 ± 3.8 mm (8 - 20) in the Eye-HS group (p < 0.001, p < 0.001, respectively). The mean OSDI scores were 13.12 ± 1.41 (10 - 15) in the Eye-AD group and 13.97 ± 2.93 (8 - 20) in the Eye-HS group (p = 0.052). Mean TMH and TMA were 306.48 ± 7.29 µm and 0.22 ± 0.004 mm², respectively, in the Eye-AD group, and 312.94 ± 5.31 µm and 0.027 ± 0.005 mm², respectively, in the Eye-HS group. In the CIC analyses, 22 of the samples in the Eye-AD group and 35 in the Eye-HS group had a classification of grade 0, 10 in the Eye-AD group and 5 in the Eye-HS group had a classification of grade 1, and 4 in the Eye-AD group and none in the Eye-HS group had a classification of grade 2 (p = 0.015).

Pediatric patients with AD may have significant changes in conjunctival histopathology. These changes can be manifested in the tests used to measure the tear film. Dry eye was shown to be present in the majority of children with AD.