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Ameet Goyal, Devon Dipalma, Riya Goyal; The Role of Goblet Cells in the development of Dacryostenosis. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4763.
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The pathogenesis of primary acquired nasolacrimal duct obstruction(PANDO) has been evaluted in past studies. These factors include use of make-up, gender, hormone levels, and viral infection(Kashkouli MB 2010). The anatomy and physiology of the epithlelial lining of the tear duct has also been well studied by Paulsen(1998, 2003, and 2008). These studies have elucidated the tear flow physiology, microbial defense strategies, and pathophysiological processes in the nasolacrimal duct system. These studies have also revealed a mucin producing Goblet cell that lines the mucosal layer of the nasal lacrimal duct. The goblet cells are involved with the maintenance of the lubrication in order for the tears to drain through the tear duct. The purpose of this study is to better understand the role of goblet cells in patients who have PANDO.
All of the 22 patients were evaluted from one practice in ophthalmic plastic and reconstructive surgery. These patients were excluded if they had trauma, infection, previous nasal surgery, or history of nasal tumor. All of the patients complained of epihora. Other causes including dry eye, blepharitis, and anatomical abnormalities of the eye lid were excluded. Patients underwent an external dacrycystorhinostomy to remove the nasal lacimal duct mucosa. The tissue was sent in formalin. Hematoxylin and eosin stained slides cut from paraffin embedded formalin fixed tissues were examined from 22 lacrimal sac and nasal lacrimal duct mucosa. The histologic features in each biopsy included degree of inflammation and inflammatory cell types. All of this tissue was then analyzed by two independent pathologist at an academic institution.
There were 16 women and 6 men in this study. The pathologist evlauted the health of the mucosa and the number of goblet cells present in each specimen. Each one of the specimens demonstrated chronic infammation. These cell types were either lymphohistiocytic or lymphopasmacytic. There was also noted to be a complete absence of goblet cells in the female patients. The male specimens demonstrated goblet cell in the epithelial mucosa.
This study shows that there appears to be a complete loss of Goblet cells in the lining of the nasal lacrimal duct in women. The mucin producing goblet cells are important in the flow of the tears through the tear duct. The decrease in production of mucin may be a very important component to the pathophysiology of PANDO.
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