[The contribution of impression cytology towards the diagnosis of cicatricial ocular pemphigoid in its primary stages].
OBJECTIVE
To study the conjunctival epithelium by means of impression cytology in the cicatricial ocular pemphigoid (COP) in search of a possible relation between the degree of squamous metaplasia and clinical severity of the disease, in order to facilitate the earliest possible diagnosis.


METHODS
Impression cytology specimens were collected from 20 patients with varying degrees of active COP. A clinical ophthalmologic examination was performed by biomicroscopy, impression cytology, conjunctival biopsy, study of direct (IFd) and of indirect immunofluorescence (IFi).


RESULTS
Patients with COP grade I had a normal distribution of non-secretory epithelial cells with a decrease in goblet cell density of around 85% compared to control and mucin content was decrease. Patients with grade II showed a slight degree of squamous metaplasia. Goblet cell density decreased by around 95% and mucin content was scarce. Patients with clinical grade III had a moderate degree of squamous metaplasia in non-secretory cells whilst goblet cell density decreased by around 99%; mucin content was almost zero. Patients with clinical grade IV showed a moderate to severe degree of squamous metaplasia in non-secretory cells; there was a total absence of goblet cells.


CONCLUSIONS
Conjunctival impression cytology in COP showed a significant decrease in goblet cells from the early stages of disease without significant alterations in non-secretory epithelial cells. In patients with negative IFd impression cytology could enable the identification of a possible COP.
Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Madrid, Spain.
L
L
Rivas
J
J
Murube
A
A
Rivas
O
O
Shalaby
D000368:Aged; D000369:Aged, 80 and over; D002452:Cell Count / Q000379:methods; D003228:Conjunctiva / Q000473:pathology*; D003229:Conjunctival Diseases / Q000175:diagnosis*; D003584:Cytological Techniques / Q000379:methods; D004848:Epithelium / Q000473:pathology; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D008297:Male; D008679:Metaplasia / Q000473:pathology; D008875:Middle Aged; D010390:Pemphigoid, Benign Mucous Membrane / Q000175:diagnosis*