Harbiyeli Ibrahim Inan, Erdem Elif, Erdogan Seyda, Kuyucu Yurdun, Polat Sait, Yagmur Meltem
Faculty of Medicine, Department of Ophthalmology, Cukurova University, Adana, Turkey.
Faculty of Medicine, Department of Pathology, Cukurova University, Adana, Turkey.
Int Ophthalmol. 2019 Jul;39(7):1491-1499. doi: 10.1007/s10792-018-0963-6. Epub 2018 Jul 10.
To investigate changes in conjunctival tissue of conjunctivochalasis (CCh) patients and to determine the relationship between pathological findings and localization of loose conjunctiva.
Our study included nineteen eyes of 19 patients who were referred to Cukurova University Ophthalmology Department based on ocular surface symptoms and CCh detected in ocular examination. Amniotic membrane was applied after conjunctival excision as surgical treatment. The control group was formed with five eyes of five patients who are similar in terms of age and gender distribution with our study group. Tissue samples obtained from the study and control groups were investigated with light and electron microscopy.
Results of pathological examination of conjunctival tissues revealed increased inflammation in 13 patients (68%), lymphatic ectasia in 12 patients (63%), and loss of goblet cells in 17 patients (89%). Destruction of elastic fibers was detected in all cases by staining with elastic van Gieson. After semiquantitative assessment, varying degrees of light microscopic findings were noted considering the localization of CCh. No statistically significant relationship was observed between light microscopic findings and CCh location (p > 0.05 for all). Electron microscopic investigation revealed increase in intercellular spaces, increased cytoplasmic electron density, and the presence of slight vacuolization in cell cytoplasm, and heterochromatin clumping in nuclei of cells in conjunctival samples.
Mechanical and inflammatory factors induce development of CCh, and signs associated with these factors can be detected with light and electron microscopy of conjunctival tissue. No relationship was observed between CCh localization and pathological changes in tissues examined in our study, and large-scale case series are required to evaluate the possible effect of CCh localization on pathological findings.
研究结膜松弛症（CCh）患者结膜组织的变化，并确定病理结果与松弛结膜定位之间的关系。
我们的研究纳入了19例患者的19只眼，这些患者因眼表症状被转诊至库库洛瓦大学眼科，且在眼部检查中发现患有CCh。手术治疗为结膜切除术后应用羊膜。对照组由5例患者的5只眼组成，其年龄和性别分布与我们的研究组相似。对研究组和对照组获取的组织样本进行光镜和电镜检查。
结膜组织病理检查结果显示，13例患者（68%）炎症增加，12例患者（63%）淋巴管扩张，17例患者（89%）杯状细胞缺失。通过弹性范吉森染色在所有病例中均检测到弹性纤维破坏。经过半定量评估，考虑到CCh的定位，发现了不同程度的光镜下表现。光镜下表现与CCh位置之间未观察到统计学显著关系（所有p值均>0.05）。电镜检查显示结膜样本中细胞间隙增加、细胞质电子密度增加、细胞质中存在轻微空泡化以及细胞核中异染色质聚集。
机械和炎症因素诱导CCh的发生，并且通过结膜组织的光镜和电镜检查可以检测到与这些因素相关的体征。在我们的研究中，未观察到CCh定位与所检查组织的病理变化之间的关系，需要大规模病例系列来评估CCh定位对病理结果的可能影响。
