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Conjunctival Histopathological Changes and Clinical Tear Film in Children with Atopic Dermatitis
Alper Halil Bayat1, Gozde Aksoy Aydemir2, Emre Aydemir2
1Ophthalmology, Bahcesehir University Faculty of Medicine, Besiktas, Turkey.
Insights
Children with atopic dermatitis (AD) often experience dry eye symptoms and show significant changes in conjunctival histopathology. These ocular surface alterations can impact tear film function, as evidenced by various diagnostic tests.
Area of Science:
- Ophthalmology
- Dermatology
- Pediatrics
Background:
- Atopic dermatitis (AD) is a chronic inflammatory skin condition that can affect ocular structures.
- Understanding the ocular surface manifestations in pediatric AD is crucial for comprehensive patient care.
Purpose of the Study:
- To evaluate ocular surface changes in children diagnosed with atopic dermatitis (AD).
Main Methods:
- A prospective case-control study compared 36 children with AD (Eye-AD group) to 40 healthy children (Eye-HS group).
- Evaluated parameters included 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).
Main Results:
- Children with AD exhibited significantly reduced T-BUT and STT compared to healthy controls (p < 0.001).
- Conjunctival impression cytology revealed significant differences, with more severe grades observed in the Eye-AD group (p = 0.015).
- While OSDI scores were similar, TMH and TMA showed trends suggesting ocular surface alterations in the AD group.
Conclusions:
- Pediatric patients with AD demonstrate notable changes in conjunctival histopathology.
- These findings correlate with impaired tear film function and a high prevalence of dry eye in children with AD.
Purpose:
Evaluation of changes in the ocular surfaces in children with a diagnosis of atopic dermatitis (AD).
Methods:
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.
Results:
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).
Conclusion:
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.
