Polizzi A, Schenone M, Saccà S C, Burlando S, Freedman D, Marinari G, Cuneo S, Rovida S, Formelli F, Camerini G
Istituto Di Clinica Oculistica dell' Universita' Di Genova, Italy.
Br J Ophthalmol. 1998 Mar;82(3):303-5. doi: 10.1136/bjo.82.3.303.
Evaluation of the morphological damage to the ocular surface of patients operated for biliopancreatic diversion for pathological obesity and the correlation of impression cytology with vitamin A plasma levels, adaptometry, and other general variables.
48 patients (15 males, 33 females, age range 21-73) and 34 normal subjects were examined with fluorescein and rose bengal, a plasma dose of vitamin A, and adaptometry. The results of the various tests were subdivided into three levels (0 = normal, 1 = moderately altered, 2 = seriously altered). The impression cytology and adaptometry results were correlated with vitamin A levels and other patient data (age, nutritional condition, time since operation, percentage weight loss). All the examinations were repeated after intramuscular therapy with vitamin A.
Corneoconjunctival alterations visible with fluorescein and rose bengal staining were present in 67.7% of cases, impression cytology alterations in 93.7%, adaptometric alterations in 82.2%; vitamin A plasma levels were below normal in 95.8% of cases. After the therapy with vitamin A a significant reduction was found for every examination. The correlation between impression cytology and adaptometry and vitamin A plasma levels and between corneoconjunctival alterations and vitamin A plasma levels was significant. There was no significant correlation between impression cytology and nutritional condition, age time since operation, and percentage weight loss.
These results show impression cytology is a specific indicator for hypovitaminosis A because it is not influenced by other factors related to the general condition of the patient. Many patients with hypovitaminosis A not demonstrating ocular symptoms of changes visible with fluorescein and rose bengal showed alterations with impression cytology.
评估因病态肥胖接受胆胰分流手术患者眼表的形态学损伤，以及印迹细胞学与血浆维生素A水平、视网膜适应计测量结果及其他一般变量之间的相关性。
对48例患者（15例男性，33例女性，年龄范围21 - 73岁）和34名正常受试者进行荧光素和孟加拉玫瑰红检查、血浆维生素A剂量测定以及视网膜适应计测量。将各项检查结果分为三个等级（0 = 正常，1 = 中度改变，2 = 严重改变）。将印迹细胞学和视网膜适应计测量结果与维生素A水平及其他患者数据（年龄、营养状况、术后时间、体重减轻百分比）进行相关性分析。在肌肉注射维生素A治疗后重复所有检查。
荧光素和孟加拉玫瑰红染色可见的角膜结膜改变在67.7%的病例中存在，印迹细胞学改变在93.7%的病例中存在，视网膜适应计测量改变在82.2%的病例中存在；95.8%的病例血浆维生素A水平低于正常。维生素A治疗后，各项检查均有显著降低。印迹细胞学与视网膜适应计测量结果和血浆维生素A水平之间以及角膜结膜改变与血浆维生素A水平之间存在显著相关性。印迹细胞学与营养状况、年龄、术后时间和体重减轻百分比之间无显著相关性。
这些结果表明，印迹细胞学是维生素A缺乏症的特异性指标，因为它不受与患者一般状况相关的其他因素影响。许多维生素A缺乏症患者虽无荧光素和孟加拉玫瑰红可见的眼部症状改变，但印迹细胞学显示有改变。
