Abstract
Purpose :
To analyse 10 years data of corneal and conjunctival pathology specimens, from a tertiary eye care corneal service in the UK.
Methods :
This retrospective single-centre study was conducted from August 2010 to December 2019, to analyse demographics, characteristics and type of corneal samples sent to the ocular pathology department (Sheffield, UK) as part of the clinical practice at tertiary care hospital in the UK.
Results :
1376 corneal and conjunctival specimens were analysed from 534 patients which includes 324 (60.7%) males with mean age 58.3 (SD 20.3; range 05-103 years); 680 (49.2%) samples were taken from right eye, 1175 (85.3 %) were corneal and 201 (14.7 %) were conjunctival pathology specimens. Patient to sample ratio was 1:2.5 (534/1376) while 345 (64.6%) patients had more than one sample. 905 (65.7%; 99.5% corneal) were corneal/conjunctival impression cytology, followed by 274 (19.9%) corneal tissues and 195 (14.1 %) conjunctival tissue. Most common corneal clinical diagnosis was limbal stem cell deficiency (LSCD; n=569; 41.3%), followed by corneal regrafts (n=71; 5.2%) and Fuchs’ endothelial dystrophy (n=64; 4.7%). Most common conjunctival diagnosis was pterygium (n=50; 3.6%), followed by ocular surface neoplasia (n=39; 2.8%) and conjunctival necrosis due to chemical burn (n=13; 0.9%). Maximum number of samples were sent in 2014 (n=224; 16.3%) related to a higher proportion of corneal impression cytology specimens as part of an autologous limbal stem cell transplantation study. Moreover, in most of the cases there was a strong agreement between clinical and pathology diagnosis (n=1214; 88.3%).
Conclusions :
In our service there were more samples from males and most of the patients had more than 1 sample. More than two thirds of samples were corneal and mainly taken for impression cytology to assist in the diagnosis of limbal stem cell deficiency and assessment of response to limbal transplant treatment, after chemical burn. Most of the time clinical and pathological diagnosis was in agreement, however, there was disagreement in 162 (11.7%) samples, mainly related to a slight disparity in severity grading of LSCD.
Close collaboration with an ocular pathology service is an integral part of corneal service provision in the UK and must be encouraged. It provides essential diagnostic support to be able to deliver a safe and efficient corneal service to patients.
This is a 2021 ARVO Annual Meeting abstract.