PURPOSE: To analyze the autofluorescence (AF) properties of pinguecula using cobalt-blue and yellow filters and to investigate the nature and pathogenesis of pingueculae using histochemical and immunohistochemical staining. METHODS: Fifty pingueculae in 40 patients were included in this study. AF of the pingueculae was observed and analyzed using a cobalt-blue filter with an additional yellow filter on a slit-lamp. Hematoxylin-eosin and immunohistochemical stainings were performed on surgical specimens of pingueculae that were prepared from each patient. Immunohistochemical staining included Congo red, Oil Red O, periodic acid-Schiff (PAS), Masson's trichrome, transglutaminase-2 (TG-2), mesenchymal stem cell markers CD29 (beta-1-integrin), and CD34. RESULTS: AF images revealed hyper-AF in the pinguecula area. The AF lesions of pingueculae showed superficial punctuate erosions and avascular lesions. Deposition of eosinophilic and amorphous materials in the subepithelial layer of the pinguecula were observed on hematoxylin-eosin staining. Historeactivities to Congo red, PAS, Oil Red O, alcian blue, and Masson's trichrome were not detected, but immunoreactivities to CD29, CD34, and TG-2 were detected in the pingueculae with AF. However, CD29, CD34, and TG-2 were not detected in the pingueculae without AF. CONCLUSIONS: The AF of pingueculae may be related to CD29, CD34, and TG-2. We suggest that pingueculae with AF have a different pathogenesis compared to pingueculae without AF.
Aged ; Coloring Agents/diagnostic use ; Female ; Fluorescence ; Follow-Up Studies ; Hematoxylin/*diagnostic use ; Humans ; Immunohistochemistry ; Male ; Microscopy, Confocal/*methods ; Middle Aged ; Pinguecula/*pathology ; Retrospective Studies

PURPOSE: To establish the strength of the association between routine tear function tests and conjunctival impression cytology (CIC) and to determine whether they simulate the morphological and cytological changes that occur on the ocular surface in dry eye. What are the sensitivity, specificity and positive predictive values of these tests when CIC is considered the gold standard? METHODS: The tear film profile included tear film break up time (TBUT), Schirmer's-1, Rose Bengal scores (RBS), and impression cytology. CIC samples were obtained from the inferior bulbar conjunctiva and stained with periodic acid-Schiff and counter stained with hematoxylin and eosin. RESULTS: The mean Schirmer's value was 11.66 +/- 5.90 in patients and 17.17 +/- 2.97 in controls (p < 0.001). The mean TBUT in participants was 8.88 +/- 3.54 and 13.53 +/- 2.12 in controls (p < 0.001). Patients had a mean goblet cell density (GCD) of 490 +/- 213, while the value for controls was 1,462 +/- 661 (p < 0.001). Abnormal CIC was observed in 46.7% cases of dry eye and in 32.8% of controls. The correlation coefficient (L) for Schirmer's was 0.2 and 0.24 for participants and controls, respectively, while TBUT values were 0.26 and 0.38, RBS were 0.5 and 0.5, and GCD was 0.8 and 0.6 in cases and controls, respectively. CONCLUSIONS: GCD, RBS, and TBUT were better predictors of morphological and cytological changes in the conjunctiva than Schirmer's in dry eye syndrome. The sensitivity of tear function tests in diagnosing dry eye was TBUT > Schirmer's > RBS, and the specificity was Schirmer's > TBUT > RBS in decreasing order when CIC was considered the gold standard.
Adolescent ; Adult ; Case-Control Studies ; Child ; Conjunctiva/pathology ; Diagnostic Techniques, Ophthalmological/*standards ; Dry Eye Syndromes/*diagnosis/*pathology ; Eosine Yellowish-(YS)/diagnostic use ; Female ; Goblet Cells/pathology ; Hematoxylin/diagnostic use ; Humans ; Male ; Middle Aged ; Ophthalmology/*standards ; Periodic Acid-Schiff Reaction/standards ; Predictive Value of Tests ; Rose Bengal/diagnostic use ; Sensitivity and Specificity ; *Tears ; Young Adult