体内杯状细胞密度作为青光眼滤过手术结果的潜在指标。

In Vivo Goblet Cell Density as a Potential Indicator of Glaucoma Filtration Surgery Outcome.

作者信息

Agnifili Luca, Fasanella Vincenzo, Mastropasqua Rodolfo, Frezzotti Paolo, Curcio Claudia, Brescia Lorenza, Marchini Giorgio

机构信息

Ophthalmology Clinic Department of Medicine and Aging Science, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy.

Ophthalmology Unit, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Verona, Italy.

出版信息

Invest Ophthalmol Vis Sci. 2016 Jun 1;57(7):2928–2935. doi: 10.1167/iovs.16-19257.

DOI:10.1167/iovs.16-19257

PMID:27249666

Abstract

PURPOSE

We analyzed the preoperative conjunctival goblet cell density (GCD), MUC5AC, and HLA-DR in glaucomatous patients undergoing trabeculectomy, using laser scanning confocal microscopy (LSCM) and impression cytology (IC).

METHODS

We enrolled 57 patients undergoing trabeculectomy. At baseline LSCM and IC were performed at the site planned for surgery; LSCM was repeated after 12 months at the bleb site. The main outcomes were: GCD, mean microcyst density (MMD) and area (MMA) at LSCM, MUC5AC, and HLA-DR positivity at IC, and IOP. The relationships between baseline GCD, and 12-month IOP, MMD, and MMA were analyzed.

RESULTS

Trabeculectomy was successful in 39 patients (complete success in 27, Group 1; qualified in 12, Group 2), and unsuccessful in 18 (Group 3). At baseline IOP (mm Hg) was 27.2 ± 3.12, 27.5 ± 2.23, and 27.7 ± 1.90 in Groups 1 to 3, respectively; GCD and MUC5AC positivity were higher in Group 1 compared to Groups 2 and 3 (P < 0.05); HLA-DR, MMD, and MMA were not significantly different among the groups. At 12 months, IOP reduced by 45.3%, 35.4%, and 12.8% in Groups 1 to 3, respectively. Goblet cell density did not change in Group 1, whereas it was reduced in Groups 2 and 3 (P < 0.05), with values lower in Group 3. Mean microcyst density and MMA increased in Groups 1 and 2 (P < 0.05), with values higher in Group 1 (P < 0.05). Baseline GCD positively correlated with 12-month IOP reduction (P < 0.001, r = 0.641), MMD (P < 0.05, r = 0.454), and MMA (P < 0.001, r = 0.541).

CONCLUSIONS

Goblet cells positively affect the filtration ability after trabeculectomy; therefore, preoperative GCD could be considered as a potential in vivo biomarker of surgical success.

摘要

目的

我们使用激光扫描共聚焦显微镜（LSCM）和印迹细胞学（IC）分析了接受小梁切除术的青光眼患者术前结膜杯状细胞密度（GCD）、MUC5AC和HLA - DR。

方法

我们纳入了57例接受小梁切除术的患者。在基线时，在计划手术的部位进行LSCM和IC检查；12个月后在滤过泡部位重复进行LSCM检查。主要观察指标为：LSCM下的GCD、平均微囊肿密度（MMD）和面积（MMA）、IC下的MUC5AC和HLA - DR阳性率以及眼压（IOP）。分析了基线GCD与12个月时的IOP、MMD和MMA之间的关系。

结果

39例患者小梁切除术成功（27例完全成功，第1组；12例合格，第2组），18例失败（第3组）。基线时，第1至3组的眼压（mmHg）分别为27.2±3.12、27.5±2.23和27.7±1.90；与第2组和第3组相比，第1组的GCD和MUC5AC阳性率更高（P<0.05）；各组间HLA - DR、MMD和MMA无显著差异。12个月时，第1至3组的眼压分别降低了45.3%、35.4%和12.8%。第1组杯状细胞密度未改变，而第2组和第3组降低（P<0.05），第3组的值更低。第1组和第2组的平均微囊肿密度和MMA增加（P<0.05），第1组的值更高（P<0.05）。基线GCD与12个月时的眼压降低呈正相关（P<0.001，r = 0.641）、与MMD呈正相关（P<0.05，r = 0.454）、与MMA呈正相关（P<0.001，r = 0.541）。