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PubMed2004

Cytokeratin expression in primary epithelial cell culture from bovine conjunctiva.

Aim of the present study is to extend our previous observations on a model of primary epithelial cell culture obtained from bovine conjunctiva, and analyse the maintenance of the conjunctival phenotype, relative to cytokeratin (CK) expression, through extended periods of cultivation under different conditions. Conjunctival epithelial cells were grown in transwell filters, and cultured either under liquid covered (LC), or air-interface (AI) conditions. The physiological state of the cells was monitored daily by measurement of the trans-epithelial electrical resistance (TEER). Analysis of cytokeratin expression was then carried out at different time points (up until 14 days), and compared to the original profile of the conjunctival tissue in order to assess deviations from the primitive phenotype. Immunodetection studies, carried out by both western immunoblot and immunofluorescence analyses, revealed constant expression of the pan-epithelial marker AE3 (recognizing basic type cytokeratins), confirming the epithelial nature of the culture. Other cytokeratins characteristic of non-keratinized stratified epithelia (CK4 and CK13) were absent in corneal tissue, while in conjunctival epithelial cells were more expressed under AI than under LC culture conditions. Expression of CK12, a specific marker of corneal tissue, revealed by the antibody AE5, was never observed in conjunctival epithelial cells. These results indicate that the conjunctival phenotype is conserved during extended periods of culturing, making this system a reliable substitute of conjunctival tissue for pharmaceutical analyses.

Animals↗
PubMed1985

Unusual melanocytic nevi of the conjunctiva.

In one patient, an epithelioid cell nevus of the conjunctiva contained numerous large, unpigmented, mononucleated, binucleated, and multinucleated benign-appearing nevus cells with abundant cytoplasm and frequent intranuclear vacuoles. Despite their overall size, the cells manifested a low nuclear-cytoplasmic ratio. After a partial excision of the lesion, the remainder spontaneously regressed during a two-year period. Another patient's lesion was dominated by a proliferation of spindle nevus cells developing in a long-standing epibulbar nevus. The spindle cells were moderately pigmented, frequently located within walls of epithelial inclusion cysts, and had benign cytologic features. Finally, in a third patient with the cutaneous B-K mole syndrome, a dysplastic conjunctival nevus developed that featured intraepithelial, atypical melanocytic proliferation with superficial colonization of the substantia propria. This portion coexisted with a deeper, preexistent lesion in the substantia propria that was comprised of orderly nests of unpigmented cuboidal nevus cells surrounded by pigmented, spindle-shaped blue nevus cells--a so-called "mixed nevus."

Adolescent↗
PubMed1991

Isolated neurofibromas of the conjunctiva.

We studied four histologically verified cases of isolated neurofibromas of the conjunctiva. The histologic pattern was diffuse in two patients, plexiform in one patient, and solitary in one patient. Simple excision was curative in all cases. We emphasize the importance of distinguishing neuromas (which may be associated with multiple endocrine neoplasia) from neurofibromas.

Adolescent↗
PubMed1978

Solitary keratoacanthoma of the conjunctiva.

Two ranch workers had rapidly-growing crateriform conjunctival nodules excised without recurrence. Histopathologically, these lesions consisted of acanthotic epithelium characterized by prominent keratin formation both within cells and in horn pearls. Although both clinically and histologically they resemble squamous cell carcinoma, keratoacanthomas are benign tumors commonly thought to arise in hair follicles. The presence of these lesions on conjunctiva and other epithelia without hair in the two cases described was evidence against this hypothesis.

Adult↗
PubMedDate not supplied

Experimental infection of the conjunctival sac of lambs with Mycoplasma conjunctivae.

Ovine keratoconjunctivitis (OKC) identical to that seen in field cases was produced experimentally with 10(6) colony forming units of an isolate of Mycoplasma conjunctivae which had been passaged three times in vitro. Cytological studies showed that the peak neutrophil count in conjunctival exudate occurred 8 days after inoculation of the conjunctival sac. Rapid onset of clinical signs in the uninoculated eye showed the ease with which the organism could be transferred from affected to unaffected eyes.

Animals↗
PubMedDate not supplied

Immunohistochemical study on follicular dendritic cell of conjunctiva-associated lymphoid tissue.

We performed an immunohistochemical study of follicular dendritic cells (FDC) in the follicular area of the conjunctiva-associated lymphoid tissue (CALT). Hartley guinea pigs were sensitized with a topical application of an emulsion of ovalbumin and Freund's complete adjuvant in the eye. They were divided into four groups. The control (group A) underwent no sensitization. The sensitized animals were studied at 1 week (group B1) or 2 weeks (group B2) after the sensitization. Additional sensitization at 1 week after the initial sensitization was also performed (group C). Histological methods included methylgreen pyronine staining, alpha-naphthylacetate esterase staining, and enzyme-antibody method against S-100 protein. The uptake of topically applied peroxidase-anti-peroxidase (PAP) in CALT was also examined histologically. In each group, positive reticular patterns by alphanaphthyl acetate esterase staining and immunoperoxidase staining with anti-S-100 protein antiserum were found in the CALT follicular area. The positively stained cells were found to be dendrite cells by immunoelectronmicroscopy. An uptake of PAP was found in the CALT follicular area, suggesting the function of trapping and retaining antigen-antibody complex by FDC. It was concluded that dendritic cells in the CALT follicular area were identified to be FDC.

Animals↗
PubMedDate not supplied

Methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase-negative staphylococci from conjunctivas of preoperative patients.

To evaluate the incidence and characteristics of carriers of conjunctival methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococci (MRCNS) among preoperative patients at an eye clinic, bacterial growth was studied in 978 conjunctival specimens of 628 preoperative patients without signs of ocular infection. Specimens were evaluated for growth of bacteria on nutrient agar plate, blood agar plate, or chocolate agar plate for 2 days at 37 degrees C. Methicillin resistance was confirmed by disk diffusion and agar screening methods. Susceptibilities of the bacterial strain to ampicillin (ABPC), cefazolin (CEZ), minocycline (MINO), gentamicin (GM), erythromycin (EM), vancomycin (VCM), and ofloxacin (OFLX) were determined by the disk diffusion method. Of the 628 patients (978 eyes), 352 patients (580 eyes) had positive bacterial growth. Among them, 8 (13 eyes) had MRSA growth and 2 (4 eyes) had MRCNS growth. The rate of nasolacrimal duct obstruction was significantly higher in eyes with positive bacterial growth than in eyes with negative growth. Of the 10 patients (17 eyes) with MRSA or MRCNS growth, 8 were older than 80 years, 5 had the same bacterial strains in the anterior nares and throat, 6 had nasolacrimal duct obstruction, 3 had dry eye, and 9 had been recently hospitalized. All 10 bacterial strains were resistant to ABPC, CEZ, and EM, but were sensitive to MINO and OFLX. Five strains were resistant and 5 were sensitive to GM. Two strains examined were sensitive to VCM. After topical antibiotic use for 0.5 to 6 months, the bacterial strains were eliminated. Two of the 17 eyes with MRSA or MRCNS growth did not undergo surgery. No postoperative endophthalmitis developed in 976 of the 978 eyes. Ophthalmologists should be aware that about 50% of preoperative patients without signs of ocular infection may have bacterial growth on the conjunctiva, and that elderly patients with nasolacrimal duct obstruction, dry eye, and recent hospital stays may be carriers of MRSA or MRCNS.

Adolescent↗
PubMed2006

[MALT (Mucosal Associated Lymphoid Tissue) lymphoma of the palpebral conjunctiva].

BACKGROUND: MALT (Mucosal Associated Lymphoid Tissue) lymphomas of the conjunctiva belong to the extranodal marginal zone B-cell lymphomas. This site, while standard, is uncommon. CASE-REPORT: A pink papular tumor developed on the lower eyelid of a 59-year-old woman. Sarcoidosis was diagnosed 9 years earlier associated with mediastinal lymphadenopathy and erythema nodosum not requiring treatment. Histological examination yielded a diagnosis of conjunctival MALT lymphoma. No visceral involvement was demonstrated. Radiotherapy (30 Gy) induced a complete response. A remote lesion developed on the patient's arm 18 months later. No other sites were found. Further radiotherapy (26 Gy) again induced complete remission. No new lesions were seen after 24 months of follow-up. DISCUSSION: This case is interesting because of the association of a MALT lymphoma and previous sarcoidosis, described in the literature as "sarcoidosis-lymphoma syndrome". Association of sarcoidosis with MALT lymphoma is infrequent. Treatment of conjunctival MALT lymphoma is standardized. Radiotherapy offers excellent efficacy and is well tolerated at this site. Regular and long-term follow-up is required. Local and distant relapse can occur.

Biopsy↗
PubMed2000

Clinical effects of oleoresin capsicum (pepper spray) on the human cornea and conjunctiva.

OBJECTIVE: To evaluate the effects of oleoresin capsicum (OC) on the human cornea and conjunctiva and to test the effectiveness of topical anesthetics for relief of pain. DESIGN: Prospective, randomized clinical trial. METHODS: Forty-seven subjects were examined before and at 10 minutes and 1 hour after exposure to pepper spray during a training exercise. Eleven subjects were reexamined at 1 week after exposure. A short, subjective questionnaire was given asking subjects to rate their pain, blurring of vision, and tearing. After exposure, subjects were randomly given a placebo, a topical nonsteroidal antiinflammatory agent, or a topical anesthetic. MAIN OUTCOME MEASURES: Visual acuity and corneal sensitivity with a Cochet-Bonnet aesthesiometer (scale of 1-6 cm) was measured and the eyes were examined with a portable slit lamp using fluorescein. Symptoms of pain, blurring of vision, and tearing were recorded in a ranking of 0 to 10. RESULTS: Visual acuity was unaffected by exposure to pepper spray. Corneal sensitivity was reduced from a pretest mean of 5.7 cm to a posttest mean of 0.6 cm 10 minutes after exposure. At 1 hour, the mean corneal sensitivity had recovered to 2.9 cm. Twenty-one percent of eyes had evidence of punctate epithelial erosions, but no corneal abrasions were found. All subjects reported significant pain, blurring of vision, and tearing at 10 minutes that was much improved by 1 hour. Topical flurbiprofen 0.03% improved symptoms in two of 11 subjects, whereas topical proparacaine hydrochloride 0.5% improved symptoms in 16 of 29 eyes. At 1 week after exposure, corneal sensation returned to baseline, and no corneal abnormalities were noted. CONCLUSIONS: The predominant symptom after exposure to OC was pain. Topical flurbiprofen was not helpful in reducing symptoms of exposure, whereas topical proparacaine was effective in relieving pain in most subjects. Corneal sensitivity was dramatically reduced at 10 minutes after exposure and was improved after 1 hour. At 1 week, corneal sensation had returned to normal, as had slit-lamp appearance on all subjects examined.

Adult↗
PubMed1978

Lymphoid lesions of the conjunctiva: relation of histopathology to clinical outcome.

A retrospective clinicopathologic study of 40 patients with lymphoid lesions of the conjunctiva demonstrated the validity of current histologic criteria in predicting clinical outcome. Overall histologic architecture as well as cytologic detail must be used to differentiate benign reactive lymphoid hyperplasia from lymphoma. Lesions verified clinically as being malignant had obvious malignant cytologic features. Clinical signs of surface follicularity, multifocality, and minimal elevation suggest benignancy. All the benign lesions, on histopathologic examination, were either follicular in architecture or composed of mature lymphocytes, and were generally restricted to the substantia propria. Bilaterality and clinical recurrence do not necessarily imply a malignant disease.

Adolescent↗
PubMed1979

XXXV Edward Jackson Memorial Lecture. Allergic granulomatous nodules of the eyelid and conjunctiva.

Twenty-two cases of granulomas of the conjunctiva or eyelids were studied, and the clinical and pathologic features were tabled. All cases showed the histologic features of the Splendore-Hoeppli phenomenon, that is a giant cell and eosinophil granulomatous reaction to an antigen-antibody precipitate originally described in relation to parasites or fungi. Seven typical cases were selected for detailed description; in four of these cases, unidentified nematodes were the cause of the condition.

Adolescent↗
PubMed1981

Iododerma of the conjunctiva and skin.

A 60-year-old white woman developed lesions of the conjunctiva and skin consistent with iododerma. Excision and examination of one of the skin lesions and the conjunctival lesion disclosed pseudoepitheliomatous hyperplasia associated with acute and chronic inflammation. The remaining lesions disappeared with cessation of iodide. We review the clinical and histopathologic features of the halodermas and discuss the ocular manifestations of iodide hypersensitivity. Recognition may require exceedingly careful testing, but such care is necessary because fatal cases of iododerma have occurred.

Conjunctiva↗
PubMed1983

Pigmented squamous cell carcinoma of the conjunctiva. A clinicopathologic ultrastructural study.

The clinical and morphologic features of a pigmented squamous cell carcinoma of the bulbar conjunctiva in a 57-year-old black man are reported. The tumor resembled the more usual epibulbar squamous cell carcinoma but had many melanin containing cells within it. Transmission electron microscopy disclosed melanosomes within squamous epithelium, melanocytes, and macrophages. The only cells within the tumor with morphologic features of a malignant neoplasm were squamous in type. The literature on this rare conjunctival tumor, which has a good prognosis following complete excision, is reviewed. Pigmented squamous cell carcinomas need to be distinguished from the more common nodular melanomas, which have a more ominous outlook.

Carcinoma, Squamous Cell↗
PubMed1983

Blue nevi of the conjunctiva.

Two examples of conjunctival blue nevi are presented. The clinical and histologic features of these lesions are not in accord with descriptions of blue nevi in the ophthalmic literature. In both cases, the nevi's clinical appearance was brown instead of blue; the nevi could be moved with the conjunctiva over the sclera; and they were not present at birth. Histologically, they demonstrated subepithelial, spindle-shaped melanocytes. The location of the cells was no deeper than that of common acquired compound or subepithelial conjunctival nevi.

Adult↗
PubMed1987

Pseudoexfoliative fibrillopathy in the conjunctiva. A relation to elastic fibers and elastosis.

Pseudoexfoliative (PSX) material in the conjunctiva was found to have a close association with elements of the elastic system in 13 eyes of patients with PSX disease studied ultrastructurally. Pseudoexfoliation aggregates were rare within vascular walls but frequent in proximity to the plasmalemma of stromal fibroblasts. No amyloid was found. A striking feature was the association of PSX fibers with the elastosis seen in many of the specimens. Typical PSX fibers were present in clumps of oxytalan and around small elastic fibers. In five cases with more advanced elastosis, the aggregates of PSX fibers were larger and their usual loose fibrogranular matrix was extensively replaced by a dense elastotic one. Morphology of PSX here varied from typical to thicker, fragmented, and sometimes nondiagnostic fibers. This intermingling of PSX and elastotic materials suggested that PSX fibrillopathy is itself a type of elastosis, possibly resulting from abnormal aggregation of components related to elastic microfibrils.

Actin Cytoskeleton↗
PubMed1989

Long-term morphologic effects of antiglaucoma drugs on the conjunctiva and Tenon's capsule in glaucomatous patients.

Conjunctival and Tenon's capsule biopsies from two patient groups were quantitatively analyzed by light microscopy. Group A consisted of 20 patients with a primary glaucoma for whom surgery was a planned primary treatment modality. Group B was comprised of 20 patients with a primary glaucoma who had received at least two types of antiglaucoma topical medication, for a minimum of 1 year (mean, 7.7 years) before surgery. All slides were examined by two masked observers. A significant increase in the number of macrophages, lymphocytes, mast cells, and fibroblasts in the conjunctiva and Tenon's capsule and a significant decrease in the number of epithelial goblet cells were seen in the group that received long-term drop therapy. These results suggest that exhaustive medical therapy, before surgery is offered, increases the number of tissue inflammatory cells. It is possible this may enhance the risk of external bleb scarring and filtration surgery failure.

Combined Modality Therapy↗
PubMed1990

Immunopathology of cicatricial pemphigoid affecting the conjunctiva.

Conjunctival biopsy specimens from 13 patients with cicatricial pemphigoid and from 13 age-matched healthy individuals undergoing cataract surgery were analyzed by light microscopy and immunohistochemical techniques, including a panel of monoclonal antibodies used to characterize inflammatory mononuclear cell phenotypes. Results of histologic examination of cicatricial pemphigoid specimens showed typical squamous metaplasia, vasculopathy, increased numbers of mast cells, and abundant plasma cells. All cicatricial pemphigoid specimens demonstrated immunoreactants at the epithelial basement membrane zone (BMZ). Epithelium of cicatricial pemphigoid conjunctiva showed significantly more T-helper cells (CD4+), dendritic cells (CD1+), and macrophages (CD14+), and a significantly higher helper/suppressor ratio than did controls. In the substantia propria, pemphigoid specimens showed dramatically increased inflammatory infiltrate with significantly more cells staining, in order of frequency, for T cells (CD3+, CD5+), T-helper cells (CD4+), T-suppressor cells (CD8+), macrophages (CD14+, Mac-1+), and dendritic cells (CD1+, HLA-DR+). Ten percent of these cells expressed interleukin-2 receptor protein (CD25+), indicating T-cell activation.

Aged↗
PubMed1993

The conjunctiva in acute and chronic mucous membrane pemphigoid. An immunohistochemical analysis.

BACKGROUND: The mechanism of chronic progressive conjunctival cicatrization in mucous membrane pemphigoid is not well understood, and current therapy is often of limited use. Rapid progression of cicatrization follows exacerbations of clinical inflammation, and the investigation of immune mechanisms related to disease activity may provide a clue for more effective therapeutic strategies. METHODS: The authors undertook an immunohistochemical study, using monoclonal and polyclonal antibodies in glycol methacrylate-embedded tissues, of epibulbar conjunctival biopsy specimens obtained from 20 patients with ocular cicatricial pemphigoid and from 12 matched healthy controls. The study patients were classified according to the ocular disease activity as acute ulcerative (n = 4), subacute (n = 8), and chronic (n = 8). RESULTS: The composition of the subepithelial cellular infiltrate varied with disease activity. Acute disease was characterized by an abundance of macrophages and neutrophils. The number of T lymphocytes was significantly raised in all the disease groups, but were most marked in subacute disease. Of the T-cell subsets, there were more CD8- than CD4-positive cells observed, except in acute disease where there were equal numbers. Only approximately 5% of the T cells in all disease groups were activated as demonstrated by expression of interleukin-2 receptor. There was increased expression of major histocompatibility complex class II (MHC II) molecules on macrophages, fibroblasts, and other cells in all the groups. The number of B cells and natural killer cells was not increased. Staining for the fibrogenic cytokines, transforming growth factor-beta (TGF-beta), platelet-derived growth factor, and basic fibroblast growth factor was found in both pemphigoid patients and control persons, but the intensity of TGF-beta staining was significantly greater in acute disease. CONCLUSIONS: The composition of the cellular infiltrate in the bulbar conjunctiva depends on clinical disease activity. The numbers of neutrophils and macrophages seem to reflect clinical disease activity. Fibrogenic cytokines, especially TGF-beta, may play an important role in the formation of conjunctival scar tissue.

Acute Disease↗