Abstract
Purpose: :
Impression cytology is a useful and minimally invasive biopsy to collect the superficial layers of the ocular surface. The purpose of this study was to evaluate the changes of conjunctival epithelium between before and after impression cytology by using a new in vivo laser scanning confocal microscope (Heidelberg Retinal Tomograph II Rostock Cornea Module: HRT–II RCM).
Methods: :
Three healthy volunteers (6 eyes) participated in this study. After topical anesthesia was applied, cellulose acetate filters (6 x 6 mm) were pressed onto the bulbar temporal (3 eyes) and nasal (3 eyes) regions for 5 seconds. Impression cytology specimens were stained by PAS. Conjunctival epithelia were examined with HRT–II RCM before, immediate after, and 1 week after the impression cytology.
Results: :
HRT–II RCM examination revealed that superficial bulbar conjunctiva before the impression cytology exhibited superficial epithelial cells with bright nuclei and large round hyperreflective goblet cells. Goblet cells in the nasal region were denser than in the temporal region. A few layers of conjunctival epithelial cells with relatively small nuclei and no goblet cells were observed immediate after the impression cytology. By slit lamp examination, conjunctival epithelial defects were not seen 1 week after the impression cytology in all subjects. Normal superficial epithelial cells and goblet cells could be observed in all subjects 1 week after the impression cytology, measured by using HRT–II RCM.
Conclusions: :
Because HRT–II RCM revealed that several conjunctival epithelial cells remain even immediate after the procedure, and normal epithelial cells and goblet cells were recovered in 1 week, we confirm that the impression cytology is a safe and minimally invasive method to evaluate the features of the ocular surface.
Keywords: conjunctiva • microscopy: confocal/tunneling • cornea: epithelium