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Naoko Shibata, Kazuyuki Sasaki, Nobuaki Yamanaka, Natsuko Hatsusaka, Hiroshi Sasaki; Applicability of detecting auto fluorescence as early sign of pinguecula. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2750.
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© ARVO (1962-2015); The Authors (2016-present)
To confirm the clinical significance of auto-fluorescence appearing in conjunctival lesions, specifically, pterygium and pinguecula, they were examined by Ultraviolet Fluorescence Photography (UVFP) using a home-made device. And to investigate the histopathology of conjunctival tissues corresponding with UVFP-positive areas in the living eye, excised pterygium was also examined.
UVFP was performed on 126 eyes of 63 volunteers (mean age 33.2 ranging from 21 to 61 years old) recruited at the Eye Clinic of Kanazawa Medical University Hospital (Group A) and five eyes of five patients with advanced pterygium (age: 66 - 85 years old) received pterygium surgery (Group B). Informed consents were obtained before UVFP and where applicable, agreement for histopathological examination of excised tissues was acquired prior to surgery. HE staining and Elastic Masson staining were performed on the excised specimens.
A home-made UVFP apparatus was used to detect auto-fluorescence in conjunctival areas adjacent to the limbus where pingueacula and pterygium were commonly seen. Among Group A, 28 of 101 eyes (27.7%) with no observable pinguecula and 25 eyes with observable pinguecula (100%) all showed auto-fluorescence. In Group B, strong auto-fluorescence was noted within the pterygium proper, and weak punctate auto-fluorescence also seen in the the peripheral area of pterygium. Characteristic histopathological finding of pterygium corresponding with the auto-fluorescence showed an increase in elastoid fibers. This increasing lamination of elastoid fibers was a localization marker as it was also observed in the peripheral areas of the pterygium.
The presence of elastic fiber layers beneath conjunctival epithelium corresponds well with auto-fluorescence, the latter therefore can be used as a marker of developing pinguecula. UVFP using our home-made device therefore appears highly useful for diagnosing early pinguecula as a clinical routine.
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