title: Repeated applications of impression cytology to increase sensitivity for diagnosis of conjunctival intraepithelial neoplasia.
abstract: OBJECTIVE
  To increase sensitivity of impression cytology (IC) for the diagnosis of conjunctival intraepithelial neoplasia (CIN) by three repeated applications of IC.
  
  
  METHODS
  This study included 35 eyes with a clinical diagnosis of CIN and 6 eyes with pinguecula as control. All eyes received IC by three consecutive applications of the cellulose acetate filter paper. All eyes in the CIN group had subsequent surgical excision with histopathological evaluation. The sensitivity of each application of IC for the diagnosis of CIN was determined.
  
  
  RESULTS
  In the control group, all IC specimens were negative for CIN. In the CIN group, with positive histopathology in all cases, the first IC was positive in 17 eyes (56.7%), showed atypical squamous cells indefinite for dysplasia (ASCID) in 8 (26.7%) and was negative in 5 (16.6%). The second application was positive in 25 eyes (83.3%), showed ASCID in 3 (10%) and was negative in 2 (6.7%). The third application was positive in 26 eyes (87.7%), showed ASCID in 3 (10%) and was negative in 1 (3.3%). The second application resulted in a statistically significant higher positive yield than the first application (p=0.009), with no significant difference between the second and the third applications (p=0.12).
  
  
  CONCLUSIONS
  Consecutive repeated applications of filter paper significantly increased the diagnostic sensitivity of IC for the diagnosis of CIN.
authors.affiliation: Farabi Eye Hospital, Qazvin Square, South Kargar Street, Tehran 16366, Iran. akheirkh@yahoo.com
authors.forename: Ahmad
authors.initials: A
authors.lastname: Kheirkhah
authors.forename: Mirgholamreza
authors.initials: M
authors.lastname: Mahbod
authors.forename: Farzad
authors.initials: F
authors.lastname: Farzbod
authors.forename: Mehdi Khodaparast
authors.initials: MK
authors.lastname: Zavareh
authors.forename: Mahmoud Jabbarvand
authors.initials: MJ
authors.lastname: Behrouz
authors.forename: Hassan
authors.initials: H
authors.lastname: Hashemi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000601:surgery; D003230:Conjunctival Neoplasms / Q000175:diagnosis* / Q000601:surgery; D003581:Cytodiagnosis; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity