Histopathological parameters in pterygia and significant clinical correlations

Abstract

Purpose:To evaluate the clinical and histopathological parameters of pterygium to determine significant correlations between parameters that can affect management strategies.Methods:A total of 47 pterygia were clinically examined and excised for histopathological evaluation of epithelial and stromal changes. Some samples were immunostained with P53 (a protein of 53 kilodalton used as dysplastic epithelial marker), CD20 (CD/cluster of differentiation, are group of surface receptors providing targets for cellular immunophenotyping, CD20 as a B lymphocyte marker), CD 3 (as T lymphocyte marker) or vascular endothelial growth factor (VEGF/as vascular marker).Results:Most patients were male (59.6%). Cosmetic complaints (83%), grade II redness (61.7%), grade 2 extension (63.8), and associated astigmatism of <2.5 D (83%) were observed. Histopathological features included solar elastosis (100%), squamous hyperplasia (83%), increased stromal vascularity with hemorrhage (76.6%), and lymphocytic stromal infiltration, perivascular distribution, and mild epithelial lymphocytic exocytosis in 72.3%, 74.5%, and 70.2% of cases, respectively. Other changes included goblet cell hyperplasia (31.9%), prominent epithelial pigmentation (48.9%), and, most importantly, epithelial atypia (53.2%). Clinical redness was significantly correlated with vascularity, epithelial hyperplasia, and lymphocytic stromal infiltration; lymphocytic stromal infiltration was also significantly correlated with pterygium extension and with low astigmatism.Conclusion:The inflammatory response was mild in most cases and the density was not significantly correlated with any clinical parameter. Vascularity was related to clinical redness. Treatment with anti-VEGF may be beneficial, even for grade 1 pterygia that are not dominantly fibrotic.

Primary pterygium is not associated with corneal endothelial cell decrease in a rural Chinese population

“…7,22 Moreover, the levels of these pathogenic factors may be correlated with the clinical features of the pterygium. 23,24 There might be several reasons why primary pterygium was not shown to be associated with ECD decrease in our study. Firstly, the UV exposure in our patients might not have reached the threshold to cause ECD decrease.…”

“…It has been shown that pterygia with at least intermediate fleshiness, redness and extent have higher expression of extracellular matrix modulators 23 and chronic inflammation in the corneal stroma. 24 The eyes in our population may not have these clinical features and thus not induce the inflammatory changes that may be associated with ECD reduction. Thirdly, UV radiation may cause an ECD decrease in both eyes of patients, irrespective of pterygium development.…”

Primary pterygium was not associated with corneal endothelial cell decrease in a rural Chinese population

“…Pterygium with intermediate fleshiness was shown had higher expression of extracellular matrix modulators [21]. Pterygium with intermediate redness and extent were also shown to have higher levels of chronic inflammation in the corneal stroma [22]. The eyes in our studies might have relatively small and less fresh pterygium since cataract surgery was indicated to these eyes.…”

“…These modulators have been shown to be expressed in pterygium tissue or the cornea underlying or adjacent to the pterygium [7, 20]. Moreover, the levels of these pathogenic factors may be correlated with the clinical features of the pterygium [21–22].…”

Serum Fibroblast Growth Factor 21 in Patients with and without Pterygia

“…Finding appropriate pharmacological therapy options for patients who do not wish to undergo surgery is a significant priority. [27] It is hoped that some non-surgical treatment methods and prophylactic procedures will soon be introduced.…”