The Dry Eye Zone

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Abstract: In vivo confocal microscopy of Sjogrens goblet cells

In vivo confocal microscopy of conjunctival goblet cells in patients with Sjogren syndrome dry eye.
Br J Ophthalmol. 2009 Dec 2. [Epub ahead of print]
Hong J, Zhu W, Zhuang H, Xu J, Sun X, Le Q, Li G, Wang Y.
Eye & ENT Hospital, School of Shanghai Medicine, Fudan University, China.

BACKGROUND: To study the morphology and the density of conjunctival goblet cells (GCs) in patients with Sjögren's syndrome dry eye with in vivo laser scanning confocal microscopy (LSCM), and to explore its correlation with the goblet cells (GCs) density detected by impression cytology in vitro.

METHODS: A total of 43 Sjögren's syndrome dry eye patients were recruited. All were required to fill in the Ocular Surface Disease Index Questionnaires. The tear break-up time was measured, followed by corneal fluorescein staining examination and Schirmer I test. The images of conjunctiva were taken by the Heidelberg retina tomography (HRT-II)/Rostock cornea module. Finally, the specimens for impression cytology were obtained. SPSS 13.0 software was used to analyze the data.

RESULTS: Tear film function test showed that all patients had moderate to severe dry eye. The goblet cell in LSCM images was characterized as a large hyperreflective oval-shape cell with relatively homogeneous brightness. Though GCs density assessed by LSCM (332 +/- 137) cells/mm(2) was higher than that measured by impression cytology (200 +/- 141) cells/mm(2), they showed a significant positive correlation, rho=0.908 (p<0.05).

CONCLUSION: Conjuctival GCs could be easily discriminated under the LSCM. LSCM may be a valuable tool in monitoring the progress and the follow-up of patients with Sjögren's syndrome dry eye.