title: Limbal stem cell deficiency in chronic and delayed-onset mustard gas keratopathy.
abstract: OBJECTIVE
  To evaluate limbal stem cell deficiency (LSCD) using impression cytology in patients with chronic and delayed-onset mustard gas keratopathy (MGK).
  
  
  METHODS
  Prospective observational case series.
  
  
  METHODS
  Thirty-five eyes of 18 patients (all male) with MGK were included.
  
  
  METHODS
  A consecutive series of patients with MGK underwent impression cytology. Finding of goblet cells on the corneal side of specimens was considered as LSCD. Severity of corneal clinical manifestation was graded as mild, moderate, and severe in each quadrant. Relation between impression cytology findings and clinical grading was evaluated.
  
  
  METHODS
  Impression cytology findings and clinical grading.
  
  
  RESULTS
  There was LSCD in at least 1 quadrant of cornea in all 35 eyes (100% of cases). No differences were found between impression cytology findings (positive vs. negative for corneal goblet cells) among different quadrants (P = 0.378). Clinical grading was the same between nasal and temporal quadrants (P = 0.266) and between superior and inferior quadrants (P = 0.263). By combining superior and inferior quadrants (vertical zone) and nasal and temporal quadrants (horizontal zone), corneal clinical grading was more severe in horizontal versus vertical zones (P<0.001). There was no relation between LSCD and corneal clinical severity (P = 0.893).
  
  
  CONCLUSIONS
  A varying degree of LSCD was demonstrated in all patients with chronic or delayed-onset MGK using impression cytology. Corneal clinical manifestations are more severe in nasal and temporal quadrants. There was no relation between impression cytology findings (positive vs. negative for goblet cells) and corneal clinical grading. Other factors, such as perilimbal conjunctival ischemia, may play a role.
authors.affiliation: Labbafinejad Medical Center, Shahid Beheshti University, Tehran, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Baradaran-Rafii
authors.forename: Mohammad-Ali
authors.initials: MA
authors.lastname: Javadi
authors.forename: Mozhgan
authors.initials: M
authors.lastname: Rezaei Kanavi
authors.forename: Medi
authors.initials: M
authors.lastname: Eslani
authors.forename: Hosein
authors.initials: H
authors.lastname: Jamali
authors.forename: Farid
authors.initials: F
authors.lastname: Karimian
mesh_terms: D000328:Adult; D000682:Amyloid / Q000378:metabolism; D002057:Burns, Chemical / Q000175:diagnosis* / Q000378:metabolism; D002619:Chemical Warfare Agents / Q000009:adverse effects*; D003316:Corneal Diseases / Q000175:diagnosis* / Q000378:metabolism; D005126:Eye Burns / Q000139:chemically induced* / Q000175:diagnosis / Q000378:metabolism; D020397:Goblet Cells / Q000473:pathology; D006801:Humans; D016850:Limbus Corneae / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D009151:Mustard Gas / Q000009:adverse effects*; D011446:Prospective Studies; D013234:Stem Cells / Q000378:metabolism / Q000473:pathology*; D014792:Visual Acuity
chemical_list: D000682:Amyloid; D002619:Chemical Warfare Agents; D009151:Mustard Gas