Age-related changes of human conjunctiva on in vivo confocal microscopy

Zhu, Wenqing; Hong, Jiaxu; Zheng, Tianyu; Le, Qihua; Xu, Jianjiang; Sun, Xing‐Guo

doi:10.1136/bjo.2008.155820

Cited by 63 publications

(48 citation statements)

References 19 publications

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“…25 Goblet cell density assessment using LSCM has been used to assess ocular surface changes related to age, 26,27 Sjögren's syndrome DE, 2,19 pterygium, 28 chemical burns, 29 glaucoma treatment with preserved and unpreserved levobunolol, 30 and tafluprost therapy. 31 To date, only one cross-sectional report of GCD assessed by LSCM in CLW has been published, which showed no significant difference between CL wearers and non-CL wearers; however, that study was limited by small sample size.…”

Section: Discussionmentioning

confidence: 99%

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

Colorado

Alzahrani

Pritchard

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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Citation: Colorado LH, Alzahrani Y, Pritchard N, Efron N. Time course of changes in goblet cell density in symptomatic and asymptomatic contact lens wearers. Invest Ophthalmol Vis Sci. 2016;57:288857: -289457: . DOI:10.1167 PURPOSE. To investigate longitudinal changes in goblet cell density (GCD) in contact lens (CL) wearers who do and do not develop symptoms of dry eye (DE). METHODS.Sixty healthy individuals fitted with daily disposable hydrogel CLs and 23 agebalanced non-CL-wearing controls underwent assessment using the 5-item dry eye questionnaire, noninvasive tear film break-up time measurement, ocular surface assessment, and phenol red thread test evaluation. Laser scanning confocal microscopy (LSCM) and conjunctival impression cytology (CIC) were used to assess GCD at baseline and follow-up visits at 1 week and 1 and 6 months. After 1 week, all CL wearers were categorized as those who were and were not symptomatic based on responses to the CL dry eye questionnaire-8 (CLDEQ-8). A linear mixed-model was used to examine changes in GCD over time. RESULTS.The global mean GCD of the 83 participants at baseline (before CL wear) was 476 6 41 and 467 6 52 cells/mm 2 using LSCM and CIC, respectively. After 6 months of CL wear, GCD was reduced by approximately 13% and 29% in asymptomatic (N ¼ 29) and symptomatic (N ¼ 17) CL wearers (all P < 0.001), respectively, observed with both LSCM and CIC.CONCLUSIONS. Contact lens wear induces a reduction of GCD over 6 months, which is exacerbated in those with DE symptoms. Either LSCM or CIC can be used to assess GCD in the conjunctiva.Keywords: contact lens wear, symptoms, dry eye, conjunctival goblet cells C onjunctival goblet cells (GCs) are secretory epithelial cells responsible for the production of the mucinous component of the tear film to support the integrity of the ocular surface. A decreased number of GCs is common in conditions of dry eye (DE), 1,2 which is described as a multifactorial disorder causing damage to the ocular surface. 3 Goblet cells may also contribute to the ocular immune response, as they have been shown to secrete cytokines and modulate dendritic cell phenotype. 4 The presence of mucin during contact lens wear (CLW) promotes surface wettability and tolerance to CLW. However, a lack of mucin discharge onto the ocular surface can cause the patient to experience symptoms such as itching, burning, reduction of visual acuity, and dryness. 5Contact lens (CL) wearers frequently report symptoms of dryness but the reason for this is not completely understood. The resulting discomfort may cause CL wearers to reduce wearing time, or cease lens wear altogether. Indeed, up to 50% of wearers will discontinue CLW permanently due to DE symptoms. 6 It is therefore important to understand whether CLW causes a reduction in GCD in those who are introduced to CLW and to determine the link between GCD and DE symptoms related to CLW.Reports of the impact of CLW on conjunctival GCD are equivocal, perhaps as a result of methodologic differences in using conjunctival impr...

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Section: Discussionmentioning

confidence: 99%

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

Colorado

Alzahrani

Pritchard

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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“…According to Abdel-Khalek et al [12], based on the study of normal elderly population, the conjunctival epithelium shows irregularities in thickness and reduction of the number of goblet cells in the older age group (over the age of 80 years) [12]. On the other hand, some other reports concluded that the number of goblet cells did not vary significantly with age [13,14].…”

Section: Discussionmentioning

confidence: 97%

Conjunctival mucoepithelial hyperplasia of the elderly

Ohashi

Elsayed

T³

et al. 2015

Int Ophthalmol

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The ocular surface is exposed to many chronic inflammatory stimuli, and goblet cell hyperplasia of the conjunctiva occurs in many situations. We report two cases of epithelial goblet cell hyperplasia with nonspecific chronic inflammation which occurred on the internal canthus of elderly people. These cases shared the same clinicopathological features that mimicked neoplastic lesion macroscopically, but are composed of nonspecific inflammatory changes pathologically. Immunostaining of the tissue showed few IgG4+ plasma cells, and no neoplastic changes were observed. Both cases arose in elderly patients over the age of 80 years. Pathogenesis and clinical significance of the lesion is unclear, but it might be age related. Recognition of this diagnosis might help us avoid overdiagnosis of malignancy and to reach the correct diagnosis.

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“…We used IVCM because this technique is minimally invasive, and it is effective in evaluating the histopathology of surface disease (Mastropasqua et al 2006;Messmer et al 2006;Hong et al 2010;Le et al 2010;Wakamatsu et al 2010;Zhu et al 2010) and the toxic effects of glaucoma therapy (Arici et al 2000;Messmer et al 2006;Ciancaglini et al 2008;Martone et al 2009;Bergonzi et al 2010). Our study showed that no changes occurred throughout followup in both controls and patients treated with preservative-free timolol; on the opposite, BAK-preserved eye drops were associated with signs of ocular surface inflammation (lower goblet cell density and epithelial irregularity) after 12 months of treatment.…”

Section: Discussionmentioning

confidence: 99%

In vivo confocal microscopy of conjunctiva in preservative‐free timolol 0.1% gel formulation therapy for glaucoma

Frezzotti

Fogagnolo

Haka

et al. 2013

Acta Ophthalmologica

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ABSTRACT.Purpose: To evaluate the effects at 1 year of preservative-free timolol gel and preserved timolol eye drops on conjunctiva and tear parameters. Methods: Forty patients with primary open-angle glaucoma or ocular hypertension were randomized to the two treatment groups and compared with 20 healthy age-matched controls. Clinical tests (IOP, Schirmer I test, and lacrimal film break-up time BUT) and in vivo conjunctival confocal microscopy (IVCM) were performed in all patients at baseline and after 12 months. IVCM (HRT II Rostock Cornea Module; Heidelberg Engineering GmbH, Heidelberg, Germany) was performed after topical anaesthesia in the four cardinal locations and at the corresponding limbus to analyse conjunctiva cells. The main IVCM outcomes were goblet cell density and epithelial regularity. Results: IVCM and clinical parameters were similar in the three groups at baseline. After 12 months, intra-epithelial goblet cell density was significantly lower in the preserved (48.25 AE 7.70) than in the preservative-free beta-blocker group (86.83 AE 22.17, p < 0.001) and controls (88.9 AE 18.33, p < 0.001). The epithelial layer was significantly more regular in the preserved beta-blocker medication group than in the preservative-free beta-blocker group (p < 0.001) and the control group (p < 0.001). A significant reduction in both Schirmer I and BUT was found in the group of preserved timolol (respectively, 11.3 AE 2.97 and 8.12 AE 0.99) compared with preservative-free timolol (16.8 AE 1.83 and 11.27 AE 1.27, p < 0.001) and controls (17.8 AE 1.87 and 12.10 AE 1.28, p < 0.001). Conclusions: Based on our IVCM data, preservative-free beta-blocker gel induces less changes at ocular surface than preserved beta-blockers, a fact that should be considered to obtain less adverse effects and maximal adherence to treatment in a chronic condition such as glaucoma.

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Age-related changes of human conjunctiva on in vivo confocal microscopy

Cited by 63 publications

References 19 publications

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

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

Conjunctival mucoepithelial hyperplasia of the elderly

In vivo confocal microscopy of conjunctiva in preservative‐free timolol 0.1% gel formulation therapy for glaucoma

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