High Inflammatory Infiltrate Correlates With Poor Symptomatic Improvement After Surgical Treatment for Superior Limbic Keratoconjunctivitis
| Autor: | Devinder P. Cheema, Debra-Meghan Sanft, Pablo Zoroquiain, Miguel N. Burnier, Ana Beatriz Toledo Dias, Evangelina Esposito |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Conjunctiva Keratoconjunctivitis Acanthosis Gastroenterology Superior limbic keratoconjunctivitis 03 medical and health sciences 0302 clinical medicine Internal medicine Biopsy medicine Humans Aged Lymphatic Vessels Retrospective Studies Aged 80 and over Inflammation 030203 arthritis & rheumatology medicine.diagnostic_test business.industry Retrospective cohort study Middle Aged medicine.disease Immunohistochemistry Ophthalmology Lymphatic system medicine.anatomical_structure Cyclooxygenase 2 Patient Satisfaction 030221 ophthalmology & optometry Etiology Female Goblet Cells business |
| Zdroj: | Cornea. 37:495-500 |
| ISSN: | 0277-3740 |
| DOI: | 10.1097/ico.0000000000001508 |
| Popis: | Purpose Superior limbic keratoconjunctivitis (SLK) is a chronic and recurrent condition of unknown etiology. It is often managed conservatively, but there is a high rate of success with surgical management for severe or recalcitrant cases. The purpose of this article is to describe and analyze clinicopathological features of patients with SLK who underwent surgical treatment and their association with the clinical outcome. Methods A total of 22 eyes from 18 patients who underwent surgical SLK management were retrospectively analyzed. Clinicopathological data were collected including details of follow-up and patient satisfaction (n = 15). Moreover, 12 cases had specimens available for review of histopathologic findings and COX-2 expression analysis by immunohistochemistry. Results From a clinical perspective, 66.7% of the SLK eyes had nonmechanical factors contributing to SLK, and 66.7% of eyes demonstrated significant symptomatic improvement after surgery. Histopathological analysis of all the lesions showed acanthosis and goblet cell loss. Unexpectedly, in 93% of the eyes, dilated lymphatic vessels were found. Furthermore, a high inflammatory infiltrate correlated with minimal symptomatic improvements (P = 0.013). Moreover, COX-2 expression was higher in patients with SLK than in a normal conjunctiva (P = 0.001). Conclusions In this study, the most common systemic association with SLK was the patient's autoimmune status. Histopathological evaluation revealed that high inflammatory infiltration in the biopsy might be predictive of minimal symptomatic improvement with surgical management. Finally, the higher COX-2 expression in patients with SLK compared with that in individuals with a normal conjunctiva supports the use of anti-COX-2 drugs as a possible therapeutic target. |
| Databáze: | OpenAIRE |
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