Cvenkel B, Globocnik M
University Eye Clinic, Ljubljana, Slovenija.
Eur J Ophthalmol. 1997 Jan-Mar;7(1):19-23. doi: 10.1177/112067219700700104.
To assess the utility of exfoliative cytology in the diagnosis of chronic conjunctivitis, we compared its findings with microbiological examination and established the correlation between cytology and microbiology in 32 patients with conjunctivitis lasting four weeks or more, with a nonspecific clinical picture. The material for cytology was collected by scraping and by imprint of the ocular surface on Millipore filter paper. The specimens were stained with Giemsa. Material for bacterial culture and fluorescent antibody test for viruses and Chlamydia were obtained at the same time. In 12 patients neutrophils predominated in cytology, in six eosinophils were found and in four there were more lymphocytes. One patient had a basophilic intracytoplasmic inclusion specific for Chlamydia infection. In eight patients coagulase-negative Staphylococcus species and in one Staphylococcus aureus were isolated, in two the fluorescent antibody test for Chlamydia was positive and in three for viruses. In all patients with a positive bacterial culture, a predominance of neutrophils was observed. All patients with a positive test for viruses had lymphocytosis in conjunctival scrapings. In two patients microbiology detected Chlamydia, but characteristic intracytoplasmic inclusions were observed only in one. Scrapings gave more specific results, that correlated well with microbiology in bacterial and viral infection, whereas the results of impression cytology showed minor metaplastic changes of epithelial cells that were nonspecific for the type of inflammation. Cytology remains a useful non-invasive tool and is an adjunct to clinical and microbiological examination. It proved especially helpful in allergic conjunctivitis.
为评估脱落细胞学在慢性结膜炎诊断中的效用，我们将32例结膜炎病程持续四周或更长时间且临床表现不具特异性的患者的细胞学检查结果与微生物学检查结果进行了比较，并确立了细胞学与微生物学之间的相关性。细胞学检查材料通过刮取和将眼表印在微孔滤纸上收集。标本用吉姆萨染色。同时获取用于细菌培养以及病毒和衣原体荧光抗体检测的材料。在12例患者中，细胞学检查中中性粒细胞占主导，6例发现嗜酸性粒细胞，4例淋巴细胞较多。1例患者有衣原体感染特有的嗜碱性胞质内包涵体。8例患者分离出凝固酶阴性葡萄球菌，1例分离出金黄色葡萄球菌，2例衣原体荧光抗体检测呈阳性，3例病毒检测呈阳性。在所有细菌培养阳性的患者中，均观察到中性粒细胞占主导。所有病毒检测呈阳性的患者结膜刮片中均有淋巴细胞增多。2例患者微生物学检测出衣原体，但仅1例观察到特征性的胞质内包涵体。刮片检查结果更具特异性，在细菌和病毒感染方面与微生物学检查结果相关性良好，而印片细胞学检查结果显示上皮细胞有轻微化生改变，对炎症类型不具特异性。细胞学检查仍是一种有用的非侵入性工具，是临床和微生物学检查的辅助手段。它在过敏性结膜炎中证明特别有用。
