Abstract
AIM—To evaluate both the number and the average distribution of goblet cells, which are responsible for the production of the mucin layer of the tear film, in the bulbar conjunctiva of patients with Down's syndrome. Previous research had used the ferning test to indicate an alteration in Down's syndrome, but had not determined which film layer was involved. METHODS—The presence of goblet cells in the bulbar conjunctiva of 30 subjects (15 with Down's syndrome, and 15 normal control subjects) was evaluated using impression cytology. RESULTS—A marked reduction of goblet cells was found in the Down's syndrome group (81.4 per mm2) when compared with the control group, where (209.8 per mm2) was found. CONCLUSION—The deficit observed appears to be the cause of the tear film alterations observed in Down's syndrome. In turn, this may often lead to the formation of dry spots, and to consequent frequent infections of the anterior segment of the eye. While it is further hypothesised that the alteration of the conjunctival epithelium in Down's syndrome may be due to an altered metabolism of some element or elements, such as vitamin A, further research will be necessary to corroborate this.
Full Text
The Full Text of this article is available as a PDF (150.3 KB).
Figure 1 .
(A) Normal control subject: note the small round epithelial cells with large nuclei. Goblet cells (arrows) are abundant, plump, and oval with intensely periodic acid Schiff positive cytoplasm. (B) Down's syndrome subject: in this case goblet cells are completely absent; epithelial cells are reduced in size and polygonal nuclei are small and pycnotic.
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Egbert P. R., Lauber S., Maurice D. M. A simple conjunctival biopsy. Am J Ophthalmol. 1977 Dec;84(6):798–801. doi: 10.1016/0002-9394(77)90499-8. [DOI] [PubMed] [Google Scholar]
- Filipello M., Scimone G., Cascone G., Zagami A., Pantaleoni G. Ferning test in Down's syndrome. Acta Ophthalmol (Copenh) 1992 Apr;70(2):274–277. doi: 10.1111/j.1755-3768.1992.tb04137.x. [DOI] [PubMed] [Google Scholar]
- Hatchell D. L., Sommer A. Detection of ocular surface abnormalities in experimental vitamin A deficiency. Arch Ophthalmol. 1984 Sep;102(9):1389–1393. doi: 10.1001/archopht.1984.01040031131040. [DOI] [PubMed] [Google Scholar]
- Keenum D. G., Semba R. D., Wirasasmita S., Natadisastra G., Muhilal, West K. P., Jr, Sommer A. Assessment of vitamin A status by a disk applicator for conjunctival impression cytology. Arch Ophthalmol. 1990 Oct;108(10):1436–1441. doi: 10.1001/archopht.1990.01070120084034. [DOI] [PubMed] [Google Scholar]
- Kinoshita S., Kiorpes T. C., Friend J., Thoft R. A. Goblet cell density in ocular surface disease. A better indicator than tear mucin. Arch Ophthalmol. 1983 Aug;101(8):1284–1287. doi: 10.1001/archopht.1983.01040020286025. [DOI] [PubMed] [Google Scholar]
- Nelson J. D., Havener V. R., Cameron J. D. Cellulose acetate impressions of the ocular surface. Dry eye states. Arch Ophthalmol. 1983 Dec;101(12):1869–1872. doi: 10.1001/archopht.1983.01040020871007. [DOI] [PubMed] [Google Scholar]
- Nelson J. D. Impression cytology. Cornea. 1988;7(1):71–81. [PubMed] [Google Scholar]
- Paschides C. A., Petroutsos G., Psilas K. Correlation of conjunctival impression cytology results with lacrimal function and age. Acta Ophthalmol (Copenh) 1991 Aug;69(4):422–425. doi: 10.1111/j.1755-3768.1991.tb02016.x. [DOI] [PubMed] [Google Scholar]
- Rolando M., Terragna F., Giordano G., Calabria G. Conjunctival surface damage distribution in keratoconjunctivitis sicca. An impression cytology study. Ophthalmologica. 1990;200(4):170–176. doi: 10.1159/000310101. [DOI] [PubMed] [Google Scholar]
- Wittpenn J. R., Tseng S. C., Sommer A. Detection of early xerophthalmia by impression cytology. Arch Ophthalmol. 1986 Feb;104(2):237–239. doi: 10.1001/archopht.1986.01050140091027. [DOI] [PubMed] [Google Scholar]