Evaluation of conjunctival inflammatory status by confocal scanning laser microscopy and conjunctival brush cytology in patients with atopic keratoconjunctivitis (AKC)

摘要

Purpose: To elucidate the status of theconjunctival inflammation in atopic keratoconjunctivitis (AKC) usinglaser scanning confocal microscopy and compare the relevant findingswith conjunctival brush cytology in a prospective controlled study. Methods: Twenty eyes from 20 AKCpatients as well as 16 eyes from 16 age and sex matched normal subjectswere 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 scansunderwent evaluation for inflammatory cell densities. Results: Brush cytology specimens and invivo confocal microscopy scans from AKC patients revealed significantlyhigher numbers of inflammatory cells (p0.05). Conjunctivalinflammatory cell density showed a negative correlation with tearstability and a positive correlation with vital staining scores andconjunctival injection grades. The extent of conjunctival inflammationassessed by in vivo confocal microscopy showed a strong positive linearcorrelation with the inflammation status evaluated by brush cytology.The corneal inflammatory cell density assessed by in vivo confocalmicroscopy showed a significant negative correlation with tearstability and a positive linear correlation with corneal fluoresceinstaining. Conclusions: Confocal scanning lasermicroscopy is an efficient, noninvasive, and a promising tool for thequantitative assessment of conjunctival inflammation, a parameter ofthis new technology which correlated well with subjective and objectiveocular surface clinical findings.