Conjunctival impression cytology and tear-film changes in patients with familial Mediterranean fever.
OBJECTIVE
To evaluate the ocular surface changes and tear-film functions in patients with familial Mediterranean fever (FMF).


METHODS
This prospective case-control clinical study examined 35 patients with FMF (group 1) and 35 controls (group 2). All patients underwent a full ophthalmological examination. Ocular surface changes were evaluated by determining cell content of surface conjunctival epithelium using conjunctival impression cytology and tear-film functions using Schirmer-I, break-up time (BUT), corneal fluorescein and Rose Bengal tests. Subjective ocular complaints were scored with a four-point scale. Between-group results were compared.


RESULTS
In group 1, impression cytology revealed grade 0 changes in 15 eyes, grade 1 changes in 11 eyes and grade 2 changes in nine eyes in group 1; in group 2, it revealed grade 0 changes in 27 eyes, grade 1 changes in five eyes and grade 2 changes in three eyes (p = 0.013). Mean goblet cell density was 765 +/- 45 cells/mm(2) in group 1 and 1730 +/- 100 cells/mm(2) in group 2 (P < 0.001). Mean results on the Schirmer-I test results were 17.36 +/- 3.18 mm in group 1 and 19.60 +/- 4.17 mm in group 2 (p = 0.364). Mean BUT was 8.20 +/- 1.60 seconds in group 1 and 9.93 +/- 2.33 seconds in group 2 (p = 0.001). Mean corneal fluorescein and Rose Bengal staining scores were 3.26 +/- 1.67 and 0.96 +/- 0.71 in group 1 and 1.37 +/- 0.34 and 0.40 +/- 0.49 in group 2 (p = 0.037, p = 0.005). The presence of subjective ocular complaints was more frequent in group 1 than in group 2.


CONCLUSIONS
Despite normal tear production, the ocular surface and tear-film functions of FMF patients differ from those of healthy individuals. These changes may be related to the chronic inflammatory nature of FMF.
Karalezli
Aylin
A
Department of Ophthalmology, Rheumatology and Pathology, Baskent University School of Medicine, Ankara, Turkey. akaralezli@yahoo.com
Borazan
Mehmet
M
Yilmaz
Sema
S
Kiyici
Halil
H
Akova
Yonca Aydin
YA
D000328:Adult; D016022:Case-Control Studies; D002452:Cell Count; D003228:Conjunctiva / Q000473:pathology*; D003229:Conjunctival Diseases / Q000209:etiology / Q000378:metabolism*; D010505:Familial Mediterranean Fever / Q000150:complications / Q000378:metabolism*; D005260:Female; D020397:Goblet Cells / Q000473:pathology; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000209:etiology / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013666:Tears / Q000378:metabolism*; D055815:Young Adult