Comparative assessment of tear function tests, tear osmolarity, and conjunctival impression cytology between patients with pterygium and healthy eyes

Abstract

Purpose: To compare histologic abnormalities of tear film and tear osmolarity between normal eyes and eyes with pterygium. Methods: This was a prospective, hospital-based, case–control study involving 95 patients (65 men, 30 women) with unilateral pterygium. The tear meniscus height (TMH), Schirmer's test-1 (SCH-1) score, Rose Bengal staining (RBS) score, tear film breakup time (TBUT), tear osmolarity (TO), and conjunctival impression cytology (CIC) were assessed in both eyes. The Chi-square and Student's t -tests were used to compare the results between the two groups. P values <0.05 were considered statistically significant. Results: The mean patient age was 50.9 years, with the largest age group being the 45–55 year-old bracket across both genders. Most patients (82.1%) had nasal pterygium, and 80% were involved in outside activities. The mean assessment values in the case and control groups were as follows: TMH, 0.21 vs. 0.24 mm; SCH-1, 13.2 vs. 17.8 mm; RBS, 4.38 vs. 2.51 points; TBUT, 8.7 vs. 13.2 seconds; TO, 306 vs. 299 mOsm/L ( P < 0.001 in all cases). The proportions of abnormal assessment values in the case and control groups were as follows: TMH, 82.1% vs. 3.16%; SCH-1, 20% vs. 2.1%; RBS, 30.53% vs. 4.22%; TBUT, 61.05% vs. 6.3%; TO, 10.52% vs. 1.05%; CIC, 33.7% vs. 7.37% ( P < 0.05 for all comparisons). Conclusion: This study showed that the quantity and quality of tear film, as well as the number of goblet cells, decreased, but the tear osmolarity increased in eyes with pterygium. Furthermore, the TMH, RBS results, TBUT, and CIC have more precise state of the patient's tear condition with the disease of the pterygium.

The Effect of Autografts from the Inferior and Superior Bulbar Conjunctiva on the Ocular Surface in Primary Pterygium Surgery: A Cytology Study

“…Rivas et al 23 investigated the topographic distribution of goblet cells with impression cytology and reported densities of 331±148/mm 2 in the superior bulbar conjunctiva and 427±112/mm 2 in the inferior bulbar conjunctiva. Although Chan et al 8 demonstrated that goblet cell density increased with squamous metaplasia in pterygium tissue, a decrease in goblet cell density was observed in studies by Safarzadeh et al 24 and Julio et al 30 Labbé et al 31 explained that the change in the number of goblet cells is related to pterygium activity.…”

“…Impression cytology specimens were graded as normal or abnormal for epithelial cell density, goblet cell density, and mucin spots (goblet cell secretions). 23 , 24 …”

“…Cells were classified as type 1 epithelial cells with eosinophilic cytoplasm, type 2 goblet cells with basophilic cytoplasm, and type 3 mucin spots that stained eosinophilic. 24 , 25 , 26 , 27 After the samples were digitally recorded using the Image J processing program (Rasband, W.S., ImageJ, US National Institutes of Health, Bethesda, Maryland, USA, https://imagej.nih.gov/ij/, 1997-2018), the nuclear-to-cytoplasmic (N/C) ratio and cell density (cells/mm 2 ) were calculated.…”

Subjective Dry Eye Symptoms and Objective Ocular Surface Signs in a Civil Air Crew Population: A Cross-Sectional Study

“…After a duration of five minutes, the extent of wetting was measured in millimeters. A result of less than 10 mm was deemed abnormal [ 18 ]. Before the TBUT measurement, the precorneal tear film was stained with fluorescein.…”

Tear Film Stability After Primary Pterygium Excision Combined with Limbal Stem Cell Transplantation is Superior to Amniotic Membrane Transplantation: A Meta-Analysis

“…Pterygia can affect vision and cause redness, foreign body sensation, decreased tear lm stability, and affected patients frequently have dry eye disease (DED) symptoms [4].…”