Observation of Conjunctiva-Associated Lymphoid Tissue With In Vivo Confocal Microscopy in Healthy Patients and Patients With Meibomian Gland Dysfunction,Cornea

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Observation of Conjunctiva-Associated Lymphoid Tissue With In Vivo Confocal Microscopy in Healthy Patients and Patients With Meibomian Gland Dysfunction
Cornea ( IF 1.9 ) Pub Date : 2022-09-01 , DOI: 10.1097/ico.0000000000002910
Yuting Liu _{1,

2} , Yingbin Wang _{1,

2} , Xin Jin _{1,

2} , Nan Zhang ₁ , Yan Shi _{1,

2} , Rui Zhu _{1,

2} , Jingrao Wang _{1,

2} , Yueyan Dong _{1,

2} , Hong Zhang _{1,

2}

Affiliation

Purpose:

The purpose of this study was to assess the distribution and morphological variation of conjunctiva-associated lymphoid tissue (CALT) in healthy human subjects and patients with meibomian gland dysfunction (MGD) using laserscanningin vivo confocal microscopy.

Methods:

A total of 34 healthy subjects and 32 patients with MGD were enrolled. All subjects underwent a conventional examination consisting of slitlamp biomicroscopy, tear film break-up time, and the Schirmer test. In vivo microscopy was applied to analyze the morphological changes in the diffuse lymphoid layer and lymphoid follicles in CALT. Conjunctival impression cytology (CIC) of samples of patients' palpebral conjunctiva and immunofluorescence staining of CD4 and CD8 antibodies were also performed to indicate the immune response status of CALT.

Results:

In the MGD group, the density of diffuse lymphocytes (P < 0.001), follicles (P < 0.001), and perifollicular lymphocytes was higher (P < 0.001) and the central reflection of the follicles was stronger (P < 0.001) than in the control group, while there was no difference in the follicle area (P = 0.758). Besides, diffuse lymphocyte density was correlated with telangiectasia, and follicular center reflection intensity was correlated with plugging. CIC immunofluorescence staining showed a higher percentage of CD4⁺ (P < 0.001) and CD8⁺ (P < 0.001) cells in the MGD group than in the control group.

Conclusions:

Using laser scanning in vivo confocal microscopy and CIC immunofluorescence staining, we observed the activation of CALT in patients with MGD, and some CALT-related parameters correlated with the lid margin findings of patients with MGD.

中文翻译：

健康患者和睑板腺功能障碍患者体内共聚焦显微镜观察结膜相关淋巴组织

目的：

本研究的目的是使用激光扫描体内共聚焦显微镜评估健康人类受试者和睑板腺功能障碍 (MGD) 患者结膜相关淋巴组织 (CALT) 的分布和形态变化。

方法：

共有 34 名健康受试者和 32 名 MGD 患者入组。所有受试者均接受常规检查，包括裂隙灯生物显微镜检查、泪膜破裂时间和席默试验。应用体内显微镜分析CALT中弥散淋巴层和淋巴滤泡的形态变化。还对患者睑结膜样本进行结膜印迹细胞学检查（CIC）以及CD4和CD8抗体的免疫荧光染色以指示CALT的免疫反应状态。

结果：

MGD组弥漫性淋巴细胞( P < 0.001)、滤泡( P < 0.001)、滤泡周围淋巴细胞密度高于对照组( P < 0.001)，滤泡中央反射较强( P < 0.001)。与对照组相比，卵泡面积无差异（P = 0.758）。此外，弥漫性淋巴细胞密度与毛细血管扩张相关，滤泡中心反射强度与堵塞相关。CIC免疫荧光染色显示MGD组CD4 ⁺ ( P <0.001)和CD8 ⁺ ( P <0.001)细胞比例高于对照组。