J Korean Ophthalmol Soc.  2009 Mar;50(3):340-346. 10.3341/jkos.2009.50.3.340.

Clinical Usefulness of Conjunctival Brush Cytology in the Diagnosis of Dry Eye Syndrome

• Moon HJ
• Park CS
• Yoon KC

• KMID: 2111242
• DOI: http://doi.org/10.3341/jkos.2009.50.3.340

Abstract

PURPOSE: To investigate the clinical usefulness of conjunctival brush cytology (CBC) in the diagnosis of dry eye syndrome.
METHODS
Conjunctival impression cytology (CIC) was performed on the right eye and CBC was performed on the left eye in 24 patients with dry eye syndrome (9 patients with Sjogren's syndrome (SS) and 15 patients with non-Sjogren syndrome (Non-SS)) and 7 control subjects. The grade of squamous metaplasia was analyzed and the correlation between the grade and tear surface parameters was evaluated.
RESULTS
The squamous metaplasia grade score in CIC and CBC were 2.44+/-0.73 and 1.56+/-1.01 in SS patients (p=0.047), 1.53+/-0.74 and 0.80+/-0.78 in Non-SS patients (p=0.017), and 0.43+/-0.54 and 0.14+/-0.38 (p=0.250) in control subjects, respectively. In SS patients, the score correlated significantly with the symptom score, basal tear secretion, break-up time (BUT) and keratoepitheliopathy score in CBC (p<0.05), but did not correlate with the tear surface parameters in CIC. In Non-SS patients, the score correlated significantly with the symptom score, basal tear secretion, BUT and keratoepitheliopathy score in CBC, and with the keratoepitheliopathy score in CIC (p<0.05).
CONCLUSIONS
CBC is a more useful method than CIC in the diagnosis of dry eye syndrome.

Keyword

Conjunctival brush cytology; Conjunctival impression cytology; Dry eye syndrome; Tear surface parameter

MeSH Terms

Dry Eye Syndromes
Eye
Humans
Metaplasia
Sjogren's Syndrome
Tears

Figure

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  Figure 1. Comparison of the grade of conjuctival squamous metaplasia between conjunctival brush and impression cytology. * p value<0.05; † Non-SS: Non-Sjӧgren's syndrome; ‡ SS: Sjӧgren's syndrome.

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  Figure 2. Goblet cell density of controls, Non-SS, SS patients in conjunctival brush and impression cytology.* p<0.05 compared with control; † p<0.05 compared with Non-SS; ‡ Non-SS=Non-Sjӧgren's syndrome; § SS= Sjӧgren's syndrome.

• 

  Figure 3. Correlation between squamous metaplasia grades by conjuctival brush and impression cytology and tear surface parameters, including symptom score (A), basal tear secretion (B), tear clearance rate (C), tear break up time (D), and keratoepitheliopathy score (E) in Sjӧgren syndrome patients.

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  Figure 4. Correlation between squamous metaplasia gradesconjuctival brush and impression cytology and tear surface parameters including symptom score (A), basal tear secretion (B), tear clearance rate (C), tear break up time (D), and keratoepitheliopathy score (E) in Non-Sjӧgren syndrome patients.

Reference

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