IOVS AJP: Lung Cellular and Molecular Physiology
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(Investigative Ophthalmology and Visual Science. 2006;47:541-544.)
© 2006 by The Association for Research in Vision and Ophthalmology, Inc.
DOI:  10.1167/iovs.05-0804
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Conjunctival Surface Changes in Patients with Sjögren’s Syndrome: A Transmission Electron Microscopy Study

Dimitris I. Koufakis,1 Costas H. Karabatsas,2 Lazaros I. Sakkas,3 Athanasia Alvanou,4 Anastasios K. Manthos,4 and Dimitris Z. Chatzoulis2

1From the University of Thessaly Medical School, Larissa, Greece; the 2Departments of Ophthalmology and 3Rheumatology, University Hospital of Larissa, Larissa, Greece; and the 4Laboratory of Histology, Embryology, and Anthropology, "Aristotle" University of Thessaloniki, Greece.

PURPOSE. To demonstrate the ultrastructural appearance of the conjunctival surface epithelium in patients with Sjögren’s syndrome (SS) compared with normal subjects.

METHODS. Conjunctival tissue specimens from seven normal subjects and eight patients with SS were obtained by bulbar conjunctival biopsy and examined by transmission electron microscopy.

RESULTS. The average number of microvilli per 8.3 µm epithelial length was significantly lower in the SS group than that in the control group (19.6 ± 2.5 vs. 28.0 ± 3.4, P < 0.0001). The microvillus height (0.539 ± 0.151 µm) and height-width ratio (1.825 ± 0.549) in the conjunctival epithelium in the SS group were significantly lower than those (height: 0.946 ± 0.117 µm, P < 0.001; and height-width ratio: 3.717 ± 0.696, P < 0.0001) in normal individuals. The microvilli in the SS group were wider than those in the control group (P = 0.003). Furthermore, the average number of secretory vesicles (per 8.3 µm epithelial length) in the apical conjunctival epithelial cell was significantly reduced in the SS group (16.4 ± 6.8 vesicles), compared with the control group (34.7 ± 1.2 vesicles, P = 0.003). In addition, although the ocular surface glycocalyx (OSG) was always present in control subjects, it was not detectable in all but one of the SS conjunctival specimens.

CONCLUSIONS. The ultrastructural morphology of the apical conjunctival epithelium is altered in patients with SS. The findings suggest that an intact OSG may play a key role in the maintenance of a healthy ocular surface, possibly by preventing abrasive influences on the apical epithelial cells.






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Copyright © 2006 by the Association for Research in Vision and Ophthalmology