Department of Ophthalmology, Antalya City Hospital, Antalya, Turkey.
Department of Ophthalmology, Ankara Etlik City Hospital, Ankara, Turkey.
Int Ophthalmol. 2024 Jul 3;44(1):309. doi: 10.1007/s10792-024-03209-3.
To compare the histopathological findings of patients who had been diagnosed with dermatochalasis (DC) and had undergone upper eyelid blepharoplasty (ULB) as well as those of controls (C-Group) according to their serum vitamin D (SVD) levels.
The prospective study included 136 upper eyelid skin from 68 patients who underwent surgery for DC and 53 upper eyelid skin from 53 patients who underwent levator surgery with ULB. The DC Group was then divided into 3 subgroups according to the marginal reflex distance (MRD4). The lymphatic vessel (LV) count and diameter of the largest LV (DLLV) were recorded, the stromal collagen bed (SCB) was observed, and its depth was measured, the interfibrillar edema was examined, and the elastic fiber and macrophage counts and recorded, respectively, and then all of these were evaluated. The SVD levels were compared between the DC patients and the C-Group.
In comparison to the C-Group, significant changes were seen in the dilated LV, DLLV, SCB depth, interfibrillar edema, elastic fiber density, and macrophage count in the DC sub-Groups (P < 0.001 for all). While no difference was found between DC sub-Group 1 (MRD4 > 4 mm) and the C-Group (P > 0.05), a significant difference was found between DC sub-Group 2 (MRD4 2-4 mm) and DC sub-Group 3 (MRD4 < 2 mm) for all of the parameters (P < 0.05). A statistically significant difference was also found in the SVD levels between the DC sub-Group 1 and DC sub-Groups 2-3 (P < 0.017, P < 0.001 respectively).
According to the results of this study, SVD level was significantly lower in DC group. Moreover, an increased LV count and diameter, decreased elastic fiber count, collagen fiber and stromal edema irregularity, and increased macrophage count were found to be associated with the SVD level.
比较根据血清维生素 D(SVD)水平诊断为皮肤松弛症(DC)并接受上睑成形术(ULB)的患者与对照组(C 组)的组织病理学发现。
前瞻性研究纳入了 68 例因 DC 接受手术的患者的 136 例上睑皮肤和 53 例因 ULB 接受提肌手术的患者的 53 例上睑皮肤。然后根据边缘反射距离(MRD4)将 DC 组分为 3 个亚组。记录淋巴管(LV)计数和最大 LV(DLLV)直径,观察基质胶原床(SCB),测量其深度,检查纤维间水肿,分别检查弹性纤维和巨噬细胞计数并记录,然后评估所有这些。比较 DC 患者与 C 组的 SVD 水平。
与 C 组相比,DC 亚组的 LV 扩张、DLLV、SCB 深度、纤维间水肿、弹性纤维密度和巨噬细胞计数均有显著变化(所有 P 值均<0.001)。虽然 DC 亚组 1(MRD4>4mm)与 C 组之间无差异(P 值>0.05),但 DC 亚组 2(MRD4 2-4mm)与 DC 亚组 3(MRD4<2mm)之间的所有参数均有显著差异(P 值均<0.05)。DC 亚组 1 与 DC 亚组 2-3 之间的 SVD 水平也存在统计学显著差异(P 值分别为<0.017 和<0.001)。
根据本研究结果,DC 组的 SVD 水平明显较低。此外,发现 LV 计数和直径增加、弹性纤维计数减少、胶原纤维和基质水肿不规则以及巨噬细胞计数增加与 SVD 水平相关。