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Published on: October 13, 2017
Histological Characteristics of Patients with Chronic Dacryocystitis, Depending on the Presence of Advanced
Jens Heichel1, Marie Elisabeth Burghardt1, Hans-Gert Struck1
1Universitätsklinik und Poliklinik für Augenheilkunde, Universitätsklinikum Halle (Saale), Deutschland.
Insights
Dacryoliths (DL) do not alter histological changes in the lacrimal sac wall. Neutrophil granulocyte presence is not increased in patients with chronic dacryocystitis and dacryolithiasis.
Area of Science:
- Ophthalmology
- Pathology
Background:
- Dacryoliths (DL) are found in up to 18% of patients with chronic dacryocystitis (CDC).
- The specific role of neutrophil granulocytes in dacryolith development requires clarification.
Purpose of the Study:
- To investigate the histological differences in the medial lacrimal sac wall between patients with chronic dacryocystitis (CDC) with and without dacryoliths (DL).
- To determine if the presence of dacryoliths correlates with increased neutrophil granulocyte infiltration.
Main Methods:
- Histological examination of 40 medial lacrimal sac wall specimens from patients with CDC and lacrimal sac ectasia.
- Specimens were obtained during transcutaneous dacryocystorhinostomy.
- Histological criteria, including inflammation, fibrosis, lymphocytes, plasma cells, macrophages, and neutrophil granulocytes, were scored.
Main Results:
- No significant differences were observed in inflammation, fibrosis, lymphocytes, plasma cells, or macrophages between patients with and without dacryoliths.
- The presence and quantity of neutrophil granulocytes did not significantly differ between the two groups.
Conclusions:
- Histological changes in the medial lacrimal sac wall are independent of the presence of dacryoliths.
- Neutrophil granulocyte infiltration is not elevated in patients with chronic dacryocystitis and dacryolithiasis.
Background:
Dacryoliths (DL) are found in up to 18% of patients with chronic dacryocystitis (CDC). In particular, the role of neutrophil granulocytes in stone development needs to be clarified.
Material And Methods:
40 histological specimens from patients with CDC and existing lacrimal sac ectasia were examined. For this purpose, sections of the medial saccus wall were obtained during a transcutaneous dacryocystorhinostomy. Twenty samples showed CDC without DL (group 1), 20 patients showed advanced dacryolithiasis (group 2). The histological criteria (inflammation, fibrosis, lymphocytes, plasma cells, macrophages, neutrophil granulocytes) were scored (0 = not present; 1 = few; 2 = moderate; 3 = numerous/strongly pronounced).
Results:
The gender ratio was balanced (1 : 1; 10 female and 10 male patients per group) and the age difference between groups 1 and 2 was not significant (median 53 vs. 56 y; p = 0.482). The histological parameters showed no significant differences between groups 1 and 2 (inflammation: 39/36, p = 0.292; fibrosis: 21/20, p = 0.385; lymphocytes: 37/32, p = 0.149; plasma cells: 25/24, p = 0.407; macrophages: 19/17, p = 0.152; neutrophil granulocytes: 10/13, p = 0.197).
Conclusions:
The histological changes in the medial lacrimal sac wall are not dependent on the presence of dacryoliths. In particular, the presence of neutrophilic granulocytes is not increased in patients with long-standing dacryolithiasis.
