May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
Ocular Surface Changes in Patients With Cicatricial Pemphigoid
Author Affiliations & Notes
  • C. Valente
    Ocular Surface Research Center, Department of Neurosciences, Ophthalmology, and Genetics, University of Genoa, Genoa, Italy
  • S. Barabino
    Ocular Surface Research Center, Department of Neurosciences, Ophthalmology, and Genetics, University of Genoa, Genoa, Italy
  • C. Mingari
    DIMES, University of Genoa, Genoa, Italy
  • M. Papadia
    Ocular Surface Research Center, Department of Neurosciences, Ophthalmology, and Genetics, University of Genoa, Genoa, Italy
    IS.PRE Oftalmica, Genoa, Italy
  • F. Solignani
    Ocular Surface Research Center, Department of Neurosciences, Ophthalmology, and Genetics, University of Genoa, Genoa, Italy
  • P. Vacca
    DIMES, University of Genoa, Genoa, Italy
  • M. Bertolotto
    Ocular Surface Research Center, Department of Neurosciences, Ophthalmology, and Genetics, University of Genoa, Genoa, Italy
  • M. Rolando
    Ocular Surface Research Center, Department of Neurosciences, Ophthalmology, and Genetics, University of Genoa, Genoa, Italy
    IS.PRE Oftalmica, Genoa, Italy
  • Footnotes
    Commercial Relationships  C. Valente, None; S. Barabino, None; C. Mingari, None; M. Papadia, None; F. Solignani, None; P. Vacca, None; M. Bertolotto, None; M. Rolando, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 2365. doi:https://doi.org/
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      C. Valente, S. Barabino, C. Mingari, M. Papadia, F. Solignani, P. Vacca, M. Bertolotto, M. Rolando; Ocular Surface Changes in Patients With Cicatricial Pemphigoid. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2365. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To test the hypothesis that patients with ocular cicatricial pemphigoid (OCP) have a significant degree of conjunctival inflammation and anatomical and immunological changes of the cornea.

Methods: : Early stages OCP patients were identified, and Schirmer test, fluorescein and lissamine green staining, tear break-up time, and impression cytology of the conjunctiva were performed in 8 patients and in 8 age-matched controls. HLA-DR and CD45 expression on conjunctival cells was measured by flow cytometry. The central cornea was examined by in vivo confocal microscopy using a 40x lens and an axial resolution of 5 µm in both groups.

Results: : Statistically significant changes in corneal fluorescein staining (p<0.005), lissamine green conjunctival staining (p<0.005), HLA-DR expression (p<0.005) and CD45 (p<0.005) occurred in the study group compared to controls, while tear secretion did not show any differences. In patients with OCP confocal microscopy images obtained showed a significant lower number of epithelial cells (1238 ± 375 cc/mm2) compared to controls (1691 ± 190 cc/mm2, p<0.0001), superficial epithelial cell area considerably higher than normal, reduced nucleus/cytoplasm ratio, halos around the nuclei, and sharp borders. Numerous highly reflective dendritic-like cells were present in the epithelial cell basal layer, and their density correlated with HLA-DR expression. The stroma showed loss of keratocytes, the presence of lacunae, and tortuous subbasal nerves. No differences were recorded in endothelial cells density.

Conclusions: : In OCP the ocular surface is characterized by inflammation of the conjunctiva and immunological and structural changes of the cornea which confirm the importance of local and systemic anti-inflammatory therapy in the early stages of the disease.

Keywords: microscopy: confocal/tunneling • inflammation • conjunctiva 
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