Histopathologic and Immunohistochemical Analysis of Conjunctivochalasis
Purpose
To histopathologically and immunohistochemically investigate conjunctivochalasis (CCh) and compare it to normal conjunctival tissue.
Methods
20 consecutive pathology specimens and 5 age matched controls prospectively submitted for pathologic evaluation between 2010 and 2014.
Control tissue was harvested from Eye Bank donors with no ocular or ophthalmic surgical history. Specimens were stained with Hematoxylin and Eosin (H&E), Verhoeff-von Gieson (VVG), M2A Lymphatic endothelial marker as well as CD68+ macrophage marker. Collagen intrafibril edema, elastin fiber density, lymphatic vessel density and macrophage density were then measured using Aperio Imagescope software. Patient identifying information masked from observers. Statistical analysis performed using Mann-Whitney Test.
Results
In the H&E group Control group: mean intrafibril edema 4.1039 microns.
Cch group: mean intrafibril edema 7.5389 microns. Statistically signficant difference( Z-score 2.576, p=0.0178, p<0.05). In the VVG group Control group: mean 22.6333 elastic fibrils per 10 collagen fibers. CCh group: mean 8.92416 elastic fibrils per 10 collagen fibers. Statistically signficant difference.(z score -3.3629, p=0.0078, p<0.05). In the M2A subset Control group: 0.02786 lymphatic vessels per square millimeter. CCh group: 0.01253 lymphatic vessels per square millimeter. Statistically significant difference (z-score 3.227, p=0.00124,P<.01). In the CD68 subset Control group: 0.03825 macrophages per square millimeters. CCh: 0.11533 macrophages per square millimeters. No statistically signficant difference (z score 0.0707, p=0.4271)
Conclusion
Statistically significant increased collagen intrafibril edema, higher lymphatic vessel density and decreased elastic tissue density in the CCh subsets. More macrophages in the CCh group but not statistically significant.