The association of conjunctival snake-like chromatin with keratoconjunctivitis SICCA.

PURPOSE: This work describes the snake-like chromatin cells in the conjunctiva of patients with keratoconjunctivitis sicca (KCS), assessing the relationship between tear function parameters and the severity of the disease, and searching for any differential pattern that could lead to early and diagnosis help clarify the etiology of KCS.

METHODS

The conjunctiva of 366 eyes from 187 patients with KCS, and 30 eyes from 15 controls, were classified according to the results of the Schirmer I test, break-up time, rose Bengal staining, osmolarity, ferning tests and electrophoresis; they were then studied by impression cytology and electron microscopy.

RESULTS

Snake-like chromatin cells, other nuclear changes, and a decreased number of goblet cells were found by impression cytology in different areas of the KCS conjunctiva. The presence of snake-like chromatin was significantly correlated with the severity of the disease. No nuclear changes were found in the control group.

CONCLUSIONS

We assume these findings can be attributed to a natural regeneration of conjunctival cells and to resistance to a pathological reaction to KCS.