Conjunctival impression cytology and tear film parameters in patients with multiple sclerosis

Int Ophthalmol. 2022 Feb;42(2):593-600. doi: 10.1007/s10792-021-02031-5. Epub 2021 Oct 1.

Abstract

Purpose: To evaluate conjunctival impression cytology (CIC) findings and tear film parameters in patients with multiple sclerosis (MS) compared with controls.

Methods: Thirty-three patients with MS (MS group) and 33 age- and sex-matched healthy subjects (control group) were included in this cross-sectional comparative study. CIC grades, tear break-up time (TBUT), Schirmer 1 test results, and Ocular Surface Disease Index (OSDI) scores were compared between the two groups, and correlations between CIC grade, TBUT, Schirmer 1 test result, OSDI score, Expanded Disability Status Scale score, and disease duration were analyzed.

Results: Mean CIC grade was higher in the MS group than in the control group (1.48 ± 0.71 and 0.39 ± 0.56, respectively; p < 0.001). In the MS group, CIC of the 14 participants (42.4%) was grade 2-3. In the control group, CIC of the only one participant (3.3%) was grade 2, and none of them was grade 3. TBUT (8.12 ± 3.16, 13.06 ± 4.23 s in MS and control groups, respectively; p < 0.001) and Schirmer 1 test results (8.45 ± 5.75, 17.36 ± 10.89 mm in MS and control groups, respectively; p < 0.001) were lower, and OSDI score (36.36 ± 19.19, 13.70 ± 15.36 in MS and control groups, respectively; p < 0.001) was higher in the MS group compared to the control group.

Conclusion: In patients with MS, objective findings of dry eye, subjective symptoms related to dry eye, and CIC abnormalities, including high grades of conjunctival squamous metaplasia and goblet cell loss, are more common. Patients with MS should be monitored for ocular surface alterations and dry eye disease.

Keywords: Conjunctival squamous metaplasia; Dry eye disease; Expanded Disability Status Scale; Ocular Surface Disease Index; Schirmer test; Tear break-up time.

MeSH terms

  • Conjunctiva / metabolism
  • Cross-Sectional Studies
  • Dry Eye Syndromes* / diagnosis
  • Dry Eye Syndromes* / etiology
  • Dry Eye Syndromes* / metabolism
  • Humans
  • Multiple Sclerosis* / complications
  • Multiple Sclerosis* / diagnosis
  • Multiple Sclerosis* / metabolism
  • Tears / metabolism