Abstract

Purpose: To histopathologically and immunohistochemically investigate conjunctivochalasis (CCh) and compare it to normal conjunctival tissue.

Methods: 20 consecutive conjunctivochalasis specimens and 5 age-matched controls were submitted for pathologic evaluation between 2010 and 2017.

Control tissue was harvested from age appropriate Eye Bank donors with no ocular or ophthalmic surgical history. Specimens were stained with Hematoxylin and Eosin (H&E), Verhoeff-von Gieson (VVG), M2A (D2-40) lymphatic endothelial marker and CD68 macrophage marker. Collagen interfibril distance, elastin fiber density, lymphatic vessel density and macrophage density were measured using Aperio Imagescope software. Patient identifying information was masked from observers. Statistical analysis performed using Mann-Whitney Test.

Results: H&E Control: mean collagen interfibril distance 4.10 microns compared to CCh: mean interfibril distance 7.54 microns (p = 0.018). In the VVG Control: mean 22.63 elastic fibrils per 10 collagen fibers compared to CCh: mean 8.92 elastic fibrils per 10 collagen fibers (p = 0.007). In the M2A (D2-40) subset Control: 0.012 lymphatic vessels per square millimeter; CCh: 0.027 lymphatic vessels per square millimeter (p = 0.0124). CD68 subset Control: 0.038 macrophages per square millimeters to CCh: 0.12 macrophages per square millimeters (p = 0.045, z-score -2.00), all comparisons showed statistically significant differences.

Conclusion: Statistically significant increased collagen interfibril distance, decreased elastic tissue density, higher lymphatic vessel density and increased CD68 macrophage count occurred in the CCh subset compared to controls. These findings support the influence of mechanical and inflammatory factors as being central to causation of conjunctivochalasis.

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Citation

Citation: Henry D Perry., et al. “Histopathologic and Immunohistochemical Analysis of Conjunctivochalasis". Acta Scientific Ophthalmology 4.1 (2021): 16-21.

Copyright

Copyright: © 2021 Henry D Perry., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.