Johnson & Johnson Department of Ocular Surface and Visual Optics, Tokyo, Japan.
Invest Ophthalmol Vis Sci. 2010 Aug;51(8):3986-92. doi: 10.1167/iovs.09-4932. Epub 2010 Apr 7.
To investigate the cytologic findings of superior bulbar conjunctiva in superior limbic keratoconjunctivitis (SLK) using laser scanning confocal microscopy and impression cytology in a prospective controlled study.
Twenty-one eyes of 11 SLK patients (9 women, 2 men; mean age, 49.3 +/- 17.9 years) and 18 eyes of 9 control subjects (6 women, 3 men; mean age, 46.4 +/- 8.7 years) underwent tear function tests including vital stainings, Schirmer test, tear clearance test, digital confocal laser scanning microscopy, and conjunctival impression cytology. After confocal microscopy and impression cytology images were obtained, the mean individual epithelial cell area (MIECA), nucleocytoplasmic (N/C) ratio, and inflammatory cell density were analyzed. The correlation between confocal microscopy and impression cytology parameters was investigated.
The MIECA of SLK patients and control subjects in confocal microscopy was 786.54 +/- 463.88 microm(2) and 311.50 +/- 78.30 microm(2), respectively. The mean N/C ratio was 0.356 +/- 0.090 and 0.490 +/- 0.038, respectively. The MIECA and N/C ratio in impression cytology showed significant correlation with the corresponding confocal microscopy parameters (MIECA, P = 0.0028; N/C, P = 0.0051). The inflammatory cell density in confocal microscopy significantly correlated with superior bulbar conjunctival Rose-Bengal scores (P = 0.0264).
Laser scanning confocal microscopy seems to be an efficient noninvasive tool in the evaluation of phenotypic alterations of the conjunctival epithelium in SLK and may serve as an alternative for impression cytology. N/C ratio and inflammatory cell density appear to be two new promising parameters of in vivo confocal microscopy in the assessment of ocular surface disease in SLK.
使用激光扫描共聚焦显微镜和印迹细胞学，在一项前瞻性对照研究中，研究上直肌侧球结膜在上方性边缘性角膜结膜炎（SLK）中的细胞学表现。
21 只眼的 11 例 SLK 患者（9 名女性，2 名男性；平均年龄 49.3 +/- 17.9 岁）和 18 只眼的 9 例对照者（6 名女性，3 名男性；平均年龄 46.4 +/- 8.7 岁）接受了泪液功能测试，包括活染色、Schirmer 试验、泪液清除试验、数字共聚焦激光扫描显微镜和结膜印迹细胞学检查。在获得共聚焦显微镜和印迹细胞学图像后，分析平均单个上皮细胞面积（MIECA）、核质比（N/C）和炎症细胞密度。研究了共聚焦显微镜和印迹细胞学参数之间的相关性。
SLK 患者和对照组在共聚焦显微镜下的 MIECA 分别为 786.54 +/- 463.88 µm²和 311.50 +/- 78.30 µm²。平均 N/C 比值分别为 0.356 +/- 0.090 和 0.490 +/- 0.038。印迹细胞学中的 MIECA 和 N/C 比值与相应的共聚焦显微镜参数呈显著相关性（MIECA，P = 0.0028；N/C，P = 0.0051）。共聚焦显微镜下的炎症细胞密度与上直肌侧球结膜 Rose-Bengal 评分显著相关（P = 0.0264）。
激光扫描共聚焦显微镜似乎是一种评估 SLK 中结膜上皮表型改变的有效非侵入性工具，可作为印迹细胞学的替代方法。N/C 比值和炎症细胞密度似乎是评估 SLK 眼表疾病的共聚焦显微镜体内两个新的有前途的参数。
