Age-related changes in the reticulin fibers of the lacrimal sac

To microscopically analyze the changes in the lacrimal sac reticulin fibers with aging.

Histological evaluation of seven lacrimal sac mucosae from five Indian patients (age and sex: 43-year-old male, 55-year-old female, 58-year-old female, 65-year-old female, and 73-year-old female) was performed. All the patients were diagnosed with primary acquired nasolacrimal duct obstruction. The mucosal walls of the lacrimal sacs were harvested during dacryocystorhinostomy or dacryocystectomy surgery. The specimens were fixed in 10% formalin and special staining with reticulin. The specimens were dehydrated and embedded in paraffin and cut into 7-μm-thick sections. The ratio of flexible and fragmented/thickened fibers (ratio f/ft) was estimated subjectively with a total score of 4. The score 4 meant that all fibers are the flexible type only but that of the score 0 does no flexible fibers.

All the lacrimal sac mucosae demonstrated the subepithelial presence of reticulin fibers. As age advanced, the ratio f/ft tended to be lower, reflecting degenerative changes. The laterality difference was minimal in bilateral specimens.

The reticulin fibers were illustrated in the lacrimal sacs and demonstrated degenerative changes with advancing age. These changes may potentially alter the tissue tonicity and contribute to the pathogenesis of lacrimal drainage disorders as the age increases.