Abstract
Purpose:
This study compared and analyzed the correlation between the severity of conjunctivochalasis and the findings of several immunohistochemical stains and TEM.<br />
Methods:
A prospective study was conducted on 24 eyes from 23 patients with conjunctivochalasis who had undergone excisional biopsies between June 2013 and January 2014. The severity of conjunctivochalasis was categorized as LIPCOF Grade. H&E staining, Verhoeff-Van Gieson (VVG) staining, D2-40 immunohistochemistry, TUNEL assay, and transmission electron microscopy (TEM) were used to examine excised conjunctival specimens.
Results:
Conjunctivochalas subjects were classified by severity degrees of mild to severe, using LIPCOF grade. Increased severity of conjunctivochalasis increased in the infiltration of inflammatory cells and reduced collagen fiber density on H&E staining, and it increased the degeneration of elastic fibers on VVG staining (p<0.05). Increases in the number of lymphatics and dilated lymphatics were observed on D2-40 immunohistochemistry (p<0.05). TUNEL assay revealed an increase in cell apoptosis with increasing conjunctivochalasis severity (p<0.05). TEM revealed apoptosis of conjunctival epithelial cells, destruction of nuclei, a decrease in intercellular cohesion and destruction of inter-digitation, and marked accumulation of degenerated elastic fibers.
Conclusions:
Severity-dependent associations were confirmed using H&E staining, VVG staining, D2-40 immunohistochemistry, TUNEL assay, and TEM in conjunctivochalasis. The results of our immunohistochemical studies will be the foundation of further studies in the pathogenesis of conjunctivochalasis.