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104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft 2006
Abstract
Abstract
SO.14.01 Morphological patterns of conjunctival epithelium in confocal laser scanning microscopy and impression cytology Küstner M.1, Rath R.1, Giebel J.2, Stave J.3, Guthoff R.3, Tost F.1
1Klinik und Poliklinik für Augenheilkunde, 2Anatomisches Institut, Universitätsklinikum AöR der Ernst-Moritz-Arndt Universität Greifswald; 3Klinik und Poliklinik für Augenheilkunde der Universität Rostock Objective: Cytomorphological findings of the ocular surface are an essential component of clinical stepwise diagnosis in various ocular diseases. For the evaluation of the conjunctival epithelium up to date samples had to be obtained in a minimal invasive manner for lab-technical processing and in vitro histological examination. For examining corneal histologic structures in vivo confocal laser scanning microscopy is a standard method used successfully. Now the conjunctival epithelium has been analysed by confocal laser scanning microscopy in vivo. This is a method which was so far only used for examining corneal histological structures.
Methods: The Rostock Laser Scanning microscope (RLSM) was used to aquire in vivo images of 23 healthy persons (n=214). These were analysed and compared to cytological slide preparations (n=110) of these individuals. A standardized examination was carried out: topical anaesthesia with Proparacain, confocal imaging of four different topographical regions of the bulbar conjunctiva (using RLSM), aquisition of impression cytological samples, slide preparation, PAS-hematoxylin staining and subsequent examination using light microscopy, evaluation and archiving of the confocal images. Finally the confocal laser scan images were compared to the impression cytological patterns.
Results: The identical representation level of the two compared methods (impression cytology and confocal Laser scanning microscopy) allows an adequate analysis of the patterns seen in confocal in vivo imaging. Due to the distribution of reflectors (bright pixels of the image), the diagnostic analysis of important morphological structures (cell nucleus, cytoplasm, nucleus plasma relation) of the conjunctiva is possible. Secretory cells of the epithelium (goblet cells) can be easily recognized by their size. Highly reflective pixels depict cell walls or wide intercellular spaces with high contrast.
Conclusions: The RLSM is suitable to investigate anatomic and morphological structures of the conjunctival epithelium in vivo. The distribution pattern of pixel brightness reflecting goblet cells may give information on the composition of the secretion or the functional state (hypo- or hypersecretion) of the conjunctiva.
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