Assessment of conjunctival goblet cell density using laser scanning confocal microscopy versus impression cytology.

To determine the association between conjunctival goblet cell density (GCD) assessed using in vivo laser scanning confocal microscopy and conjunctival impression cytology in a healthy population. Ninety (90) healthy participants undertook a validated 5-item dry eye questionnaire, non-invasive tear film break-up time measurement, ocular surface fluorescein staining and phenol red thread test. These tests where undertaken to diagnose and exclude participants with dry eye. The nasal bulbar conjunctiva was imaged using laser scanning confocal microscopy (LSCM). Conjunctival impression cytology (CIC) was performed in the same region a few minutes later. Conjunctival goblet cell density was calculated as cells/mm(2). There was a strong positive correlation of conjunctival GCD between LSCM and CIC (ρ=0.66). Conjunctival goblet cell density was 475±41 cells/mm(2) and 466±51 cells/mm(2) measured by LSCM and CIC, respectively. The strong association between in vivo and in vitro cellular analysis for measuring conjunctival GCD suggests that the more invasive CIC can be replaced by the less invasive LSCM in research and clinical practice.

Colorado LH ，Alzahrani Y ，Pritchard N ，Efron N ... -  《-》

Time Course of Changes in Goblet Cell Density in Symptomatic and Asymptomatic Contact Lens Wearers.

Colorado LH ，Alzahrani Y ，Pritchard N ，Efron N ... -  《-》

Conjunctival goblet cells density and preservative-free tafluprost therapy for glaucoma: an in vivo confocal microscopy and impression cytology study.

To evaluate the density of conjunctival goblet cells (GCs) in glaucomatous patients treated with preservative-free (PF) tafluprost, using laser scanning confocal microscopy (LSCM) and impression cytology (IC). Thirty glaucomatous patients (30 eyes) naive for therapy and thirty healthy subjects (30 eyes) were enrolled. Conjunctiva was examined by means of Heidelberg Retina Tomography/Rostock cornea module. Afterwards, the specimens for IC were obtained. Patients were randomized to PF-tafluprost (Group 1) or preserved latanoprost (Group 2) and controls to the vehicle of latanoprost (Group 3) or physiological buffered saline solution (Group 4). Both LSCM and IC were performed at baseline, and after the 1st and 6th months of therapy, GC density (GCD) (cells/mm(2) ) was the main outcome measurement.   Baseline. Mean GCD was 240.69 ± 25.43 and 232.65 ± 23.52, for LSCM, and 162.10 ± 23.44 and 164.71 ± 21.03 for IC in Group 1 and 2, respectively. GC density values were not significantly different in Group 3 and 4 (p > 0.05%). Month one. Mean GCD increased to 284.16 ± 43.88 and 230.62 ± 48.32 in Group 1 (p < 0.001) and to 297.86 ± 26.87 and 221.78 ± 43.02 in Group 2 (p < 0.05), measured with LSCM and IC, respectively. In Group 3, GCD decreased to 205.88 ± 25.04 and 139.54 ± 17.37 measured with LSCM and IC, respectively (p < 0.05). Month six. Mean GCD did not change in Group 1 (p > 0.05) whereas it decreased in Group 2 (p < 0.05), compared to month 1. In Group 3, GCD further decreased to 166.32 ± 22.31 and 120.76 ± 11.66, measured with LSCM and IC, respectively (p < 0.05); in Group 4, mean GCD did not change during the study period (p > 0.05). Treatment with PF tafluprost was associated with an increase in conjunctival GCD in glaucomatous eyes naïve for therapy. Further studies are mandatory to verify this finding because its validation may have important consequences in the medical management of glaucoma.

Mastropasqua L ，Agnifili L ，Fasanella V ，Curcio C ，Ciabattoni C ，Mastropasqua R ，Toto L ，Ciancaglini M ... -  《-》

Laser scanning confocal microscopy for conjunctival epithelium imaging.

Conjunctival disorders may adversely affect tear film and promote/induce the development of sicca syndrome (also known as Sjögren's syndrome). The basic diagnostics of sicca syndrome are slit lamp examination and functional tests (such as the Schirmer test, break-up time, or fluorescein/rose bengal staining). However, morphological analysis requires time and effort, both in terms of technical equipment and labor, and the results are not available immediately. In contrast, when using laser scanning confocal microscopy (LSCM), the anatomy and morphology of the conjunctival epithelium may be evaluated in vivo during the clinical examination. We examined the conjunctival epithelium of 23 subjects with healthy eyes using LSCM. We compared intraindividual morphological patterns of normal conjunctival epithelium derived from the Heidelberg Retina Tomograph II - Rostock Cornea Module (HRTII-RCM) with those from impression cytology. All examinations were performed on the conjunctiva bulbi at the 12 o'clock position, 2 mm from the limbus corneae. LSCM and impression cytology examine the conjunctival epithelium from identical perspectives. This facilitates an intraindividual comparison of morphological patterns. In addition, artifact detection and the mapping of light/dark pattern recognition of the LSCM to the microscopy of the impression cytology were reliable. LSCM allows in vivo discrimination of non-secretory from secretory cells in conjunctival epithelium. Non-secretory epithelium shows dark, light and bright cytoplasm of epithelial cells on LSCM, in contrast to impression cytology. Nucleoplasmic ratio ranged from 1:1 to 1:4. Shape, size and interior structure were reliable criteria to distinguish goblet cells from non-secretory cells. The interior structure of the goblet cells showed dark or highly reflective bright homogeneous textures. LSCM is a feasible method for examining the morphology of conjunctival epithelium using non-invasive in vivo imaging. Morphological criteria for squamous metaplasia of the conjunctiva in sicca syndrome are already known from cytology, and can be used in almost the same manner in LSCM. The separation of epithelial microcysts from small goblet cells is difficult with LSCM. Finally, the clinical application of LSCM in the staging of sicca syndrome has to be evaluated in future studies.

Jürgens C ，Rath R ，Giebel J ，Tost FHW ... -  《-》

In vivo confocal microscopy of conjunctival goblet cells in patients with Sjogren's syndrome dry eye.

Hong J ，Zhu W ，Zhuang H ，Xu J ，Sun X ，Le Q ，Li G ，Wang Y ... -  《-》