Conjunctival Epithelial Keratinization Is a Pathologic Feature of Ocular Surface Disease in Premature Ovarian Failure

Abstract

 

Abstract:

 

To describe conjunctival epithelial keratinization in 2 types of ocular surface disease and correlate to symptoms of ocular surface irritation.

 

123 women: 18 normal controls (NV), 62 with Premature Ovarian Failure (POF), and 43 with Sjogren’s Syndrome (SS) underwent standardized slit lamp exam and dry eye tests including Schirmer and tear breakup time. Symptoms were assessed with the ocular surface disease index questionnaire, (OSDI) ©. Conjunctival epithelial cells were obtained using Dacron swabs and processed for cytology via cytospin centrifugation. Cytology specimens were stained with Giemsa or fixed and processed for transmission electron microscopy (TEM), with JEOL JEM–1010. Immunohistochemistry was performed to detect CK10, a marker of keratinization using avidin–biotin–complex immunostaining method. The Kruskal–Wallis test was used to compare the median proportions of positively stained cells between the disease categories.

 

 

 

^{The POF group as compared to NV demonstrated significantly greater % CK10 (+) cells and cytology also revealed significanly more cells with folded borders, a marker of keratinization (p=0.001). This finding was confirmed by TEM that showed an increase of keratin filaments in cytoplasm. Dry eye symptoms as measured by total OSDI were minimally associated with positive CK10 in the POF group only (Spearman r (ρ) = 0.24, p=0.067).}

 

Conjunctival epithelial keratinization is a pathologic feature of ocular surface diseases such as SS and we now demonstrate this abnormality in women with POF. Keratinization can cause symptoms of irritation in ocular surface disease. Anti– keratinization therapies may be useful to improve ocular surface health and decrease irritation in patients with POF.

 

 

Keywords: cornea: tears/tear film/dry eye • conjunctiva • clinical (human) or epidemiologic studies: prevalence/incidence