title: Evaluation of conjunctival inflammatory status by confocal scanning laser microscopy and conjunctival brush cytology in patients with atopic keratoconjunctivitis (AKC).
abstract: OBJECTIVE
  To elucidate the status of the conjunctival inflammation in atopic keratoconjunctivitis (AKC) using laser scanning confocal microscopy and compare the relevant findings with conjunctival brush cytology in a prospective controlled study.
  
  
  METHODS
  Twenty eyes from 20 AKC patients as well as 16 eyes from 16 age and sex matched normal subjects were studied. The subjects underwent tear film break-up time (BUT), fluorescein and Rose Bengal staining of the ocular surface, conjunctival confocal microscopy, Schirmer test, and brush cytology. Brush cytology specimens and in vivo confocal microscopy scans underwent evaluation for inflammatory cell densities.
  
  
  RESULTS
  Brush cytology specimens and in vivo confocal microscopy scans from AKC patients revealed significantly higher numbers of inflammatory cells (p<0.05). Conjunctival inflammatory cell density showed a negative correlation with tear stability and a positive correlation with vital staining scores and conjunctival injection grades. The extent of conjunctival inflammation assessed by in vivo confocal microscopy showed a strong positive linear correlation with the inflammation status evaluated by brush cytology. The corneal inflammatory cell density assessed by in vivo confocal microscopy showed a significant negative correlation with tear stability and a positive linear correlation with corneal fluorescein staining.
  
  
  CONCLUSIONS
  Confocal scanning laser microscopy is an efficient, noninvasive, and a promising tool for the quantitative assessment of conjunctival inflammation, a parameter of this new technology which correlated well with subjective and objective ocular surface clinical findings.
authors.affiliation: Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Tais Hitomi
authors.initials: TH
authors.lastname: Wakamatsu
authors.forename: Naoko
authors.initials: N
authors.lastname: Okada
authors.forename: Takashi
authors.initials: T
authors.lastname: Kojima
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Osama M A
authors.initials: OM
authors.lastname: Ibrahim
authors.forename: Murat
authors.initials: M
authors.lastname: Dogru
authors.forename: Enrique Sato
authors.initials: ES
authors.lastname: Adan
authors.forename: Kazumi
authors.initials: K
authors.lastname: Fukagawa
authors.forename: Chikako
authors.initials: C
authors.lastname: Katakami
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tsubota
authors.forename: Jun
authors.initials: J
authors.lastname: Shimazaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fujishima
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002452:Cell Count; D002648:Child; D003584:Cytological Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000473:pathology* / Q000503:physiopathology; D007267:Injections; D007637:Keratoconjunctivitis / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D013194:Staining and Labeling; D013499:Surface Properties; D013666:Tears / Q000378:metabolism
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