Nelson J D
Dry Eye and Tear Research Center, St. Paul-Ramsey Medical Center and Ramsey Clinic, Minnesota 55101.
Cornea. 1988;7(1):71-81.
Impression cytology refers to the application of cellulose acetate filter material to the ocular surface to remove the superficial layers of the conjunctival epithelium. Impression cytology has been found to be useful in assessing the ocular surface in various dry eye disorders, such as keratoconjunctivitis sicca (KCS), cicatricial ocular pemphigoid, and vitamin A deficiency. The technique is noninvasive, is easy to perform, causes minimal discomfort to the patient, and can be used to follow changes in the conjunctival ocular surface over time. With this method, the morphology of the conjunctival ocular surface can be studied and the degree of squamous metaplasia assessed. A specific criteria based on the appearance of the epithelial cells and the density of the goblet cells can be used to assign a grade (0-3) to the ocular surface. The grade of the ocular surface is related to the degree of squamous metaplasia and usually parallels the severity of clinical disease. Impression cytology can also be used to differentiate between various dry eye disorders. Disorders that are extrinsic or environmental (such as KCS) often affect the exposed interpalpebral ocular surface before the more protected inferior palpebral ocular surface. Intrinsic surface disorders (such as ocular pemphigoid) affect the palpebral, as well as the bulbar ocular surfaces, early in the disease.
印迹细胞学是指将醋酸纤维素滤材应用于眼表以去除结膜上皮表层。已发现印迹细胞学在评估各种干眼疾病的眼表方面很有用，如干燥性角结膜炎（KCS）、瘢痕性类天疱疮性睑球炎和维生素A缺乏症。该技术是非侵入性的，易于操作，给患者带来的不适最小，并且可用于随访结膜眼表随时间的变化。通过这种方法，可以研究结膜眼表的形态并评估鳞状化生的程度。基于上皮细胞外观和杯状细胞密度的特定标准可用于为眼表评定一个等级（0 - 3级）。眼表等级与鳞状化生程度相关，通常与临床疾病的严重程度平行。印迹细胞学还可用于区分各种干眼疾病。外在性或环境性疾病（如KCS）通常在更受保护的下睑眼表之前先影响暴露的睑裂间眼表。内在性眼表疾病（如类天疱疮性睑球炎）在疾病早期就会影响睑部和球部眼表。
