Connective Tissue In Patients With Dry Eye Disease Characteristics Of The Ocular Surface Cytology

Objective:To investigate the application value of ocular surface cytology detection in the study of dry eye morbility factors and the morbility feature of dry eye in patients with connective tissue disease(CTD)by the routine examination about dry eye and ocular surface cytology analysis.Methods:There are 120 patients with CTD in the Study Group and 60 in the Control Group using the OD as the studying eyes.Do the examination of basal Schirmer's test(S-I-T),Break-Up Time(BUT),fluorescent Staining(FL) and impression cytology(IC)for all the researching eyes. The study group was divided into A,B,C and D sub-groups according to the results of BUT,SIT and FL,at the same time,do the apoptosis detection by flow cytometry for the conjunctiva impression epithelial cells.Results:(1)Prevalence of dry eye:The prevalence of the study group was 50.83%(61/120),which is higher than the control group(20.00%,15/60).There is significant difference between two groups by statistical analysis(P＜0.001).(2)BUT,S-I-T and FL results:The mean of BUT in control group(10.27±4.66) is higher than study group(7.38±6.08),and there is statistical difference between them(P＜0.001).The BUT results,which decrease progressively according the order from A to D,exist significant differences in statistic analysis(P＜0.001) between every two sub-groups in the study group,except the data between A and B group(P=0.482).The mean of S-I-T in study group(8.49±7.29) is lower than control group(12.55±5.49)and there is statistical difference(P＜0.001) between them.The S-I-T results,which decrease gradually according the order from A to D,show the same statistic results(P＜0.001) between every two sub-groups in study group,except the results between B and C group(P=0.193).The mean of FL in control group(0.43±0.93) is lower than study group(2.50±3.09)and there is significant differences in statistic analysis(P＜0.001) between the two groups.The FL results, which decrease by degrees according the order from A to D,show statistical differences (P＜0.001) between every two sub-groups in study group,except the data between C group and D group(P=0.458).(3)Impression cytology observation:The cases of grade 0,Ⅰ,Ⅱare 41,14 and 5 respectively and there is no gradeⅢin the control group.On the contrary,the cases of grade 0,Ⅰ,ⅡandⅢare 41,30,26 and 23 respectively.The results of IC grade in study group is higher than control group and we find the significant statistical difference between them(P＜0.001).The data of grade 0,Ⅰ,ⅡandⅢis 26,2,0,0 in sub-group A;14,14,3,0 in B;1,11,16,8 in C and 0,3,7,15 in Drespectively.We can see that the results of IC grade are decreasing gradually from A to D and there are significant differences in statistical analysis between every two sub-group.(4)apoptosis rate observation:apoptosis cells exist in Conjunctiva impression cells in each case of study group.The mean of apoptosis cells increased gradually from A to D,and the data are (3.30±0.24)%,(4.26±1.18)%,(10.12±4.19)%,(19.34±6.90)%respectively.The comparisons of mean between every two sub-group have significant difference by statistical analysis(P＜0.001), except the data between A and B group(P=0.352).Conclusions:(1)The prevalence and severity of dry eye in the patients with CTD in study group were higher than control group.(2)Conjunctiva impression cytology test is better than routine examination in assessing the grade of dry eye and can help making the early diagnosis about the dry eye for the patients with CTD.(3)Apoptosis is probably the vital factor of ocular surface lesion influenced by dry eye. Apoptosis detection by flow cytometry for the conjunctiva impression epithelial cells is an effective way to detected ocular apoptosis.