Assessment Of Immunological Changes Disorders In Cases Of Thyroid Eye Disease By Impression Cytology

Abstract

Background: Impression cytology (IC) is a technique which permits the retrieval of the outermost layer of ocular surface cells via the use of various types of filters, it is a minimally invasive method of evaluating human conjunctival epithelial cell morphology which could be utilized in the diagnosis of ocular surface diseases, such as thyroid eye disease (TED). Objective: Assessment of immunological changes that occurred on the ocular surface especially the conjunctiva in thyroid eye disease by impression cytology. Patients and Methods: A cross sectional observational study designed to analyze data of 40 eyes arranged into 2 groups: (Group 1: thyroid eye disease, Group 2: control) 20 eyes in each group. The study was performed in the time interval between May 2019 and December 2019. Results: Results of our study showed that TED group Hertel exophtalmometer measurement had an average of 22.6 ± 0.98 mm while control group showed an average of 17.50 ± 0.89, (65 %) of TED group showed stage 2 in impression cytology technique while most of control group (80%) showed stage 0, we also used this technique to discover the presence of inflammation and degree of it and we found that 80% of this group showed moderate degree of inflammation while impression cytology results of the control group showed that 80% of them were almost nil degree of inflammation. Conclusion: Impression cytology is a minimally invasive method of evaluating ocular surface cells, considered as the ‘gold standard’ technique for assessing cell morphology and we can use it for detection of immunological changes occurring in conjunctiva of patients with thyroid eye disease, also to demonstrate the immune state of these patients and its difference from normal persons, and this can help in diagnosis of early stage thyroid eye disease patients.