Pj. Pisella et al., Flow cytometric analysis of conjunctival epithelium in ocular rosacea and keratoconjunctivitis sicca, OPHTHALMOL, 107(10), 2000, pp. 1841-1849
Purpose: To investigate by flow cytometry and impression cytology (IC) spec
imens the inflammatory status of the conjunctival epithelium and goblet cel
l density in two series of patients with rosacea and dry eye syndrome compa
red with a population of healthy subjects.
Design: Nonrandomized, prospective, comparative case series.
Participants: Twenty-six eyes of 13 patients with rosacea, 26 eyes of 13 pa
tients with dry eye syndrome, and 24 eyes of 12 control subjects were inclu
ded in this study.
Methods: IC specimens were collected after clinical examination of the ocul
ar surface and analyzed by flow cytometry, using antibodies directed to hum
an lymphocyte antigen-DR (HLA-DR), intercellular adhesion molecule-1 (ICAM-
1) (CD 54), and the peptidic cove of the conjunctival mucin (M1/MUC5AC). Th
e percentage of positive cells was calculated and levels of fluorescence ex
pression quantified and compared with those obtained in a series of 12 heal
thy subjects.
Main Outcome Measures: Tear break-up time (TBUT), Schirmer test, fluorescei
n and lissamin green stainings, and IC were realized in this study.
Results: A significant increase of HLA-DR and ICAM-1 expressions by epithel
ial cells was consistently found in the two pathologic groups compared with
levels calculated in normal eyes. The two markers were well correlated wit
h each other and inversely with TBUT and Schirmer test. The percentage of g
oblet cells was significantly decreased in rosacea patients and in dry eye
patients compared with the normal group with a significant negative correla
tion with both HLA DR and ICAM-1 markers.
Conclusions: Ocular rosacea and keratoconjunctivitis sicca were associated
with severe ocular surface changes, such as an overexpression of inflammato
ry markers and a significant decrease in the number of goblet cells. Ophtha
lmology 2000;107:1841-1849 (C) 2000 by the American Academy of Ophthalmolog
y.