Evaluation of the ocular surface by impression cytology in patients with endometriosis
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Evaluation of the ocular surface by impression cytology in patients with endometriosis Meydan Turan 1
&
Gulay Turan 2
&
Akin Usta 3
Received: 17 September 2019 / Revised: 5 December 2019 / Accepted: 23 December 2019 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objective The aim of this study was to investigate the effect of endometriosis on the ocular surface. Methods A total of 50 patients were included in the study and divided into two groups. Group 1 consisted of 25 patients with endometriosis. Group 2 had 25 control patients. All patients underwent complete ophthalmic examination, and the right eyes were included in the study. To evaluate the ocular surface, both groups were tested with the following: the Schirmer I test, tear breakup time (TBUT), the conjunctival impression cytology (CIC), and the Ocular Surface Disease Index (OSDI). The results were subsequently compared. Results The average Schirmer I test results were 8.40 ± 2.74 mm in group 1 and were significantly lower in patients with endometriosis (P < 0.001). The average TBUT test results were 9.04 ± 3.61 s in group 1 and were significantly lower in patients with endometriosis (P < 0.001). The average OSDI results were 24.04 ± 9.29 in group 1 and were significantly higher in patients with endometriosis (P < 0.001). The average CIC results were 1.76 ± 0.88 in group 1 and were significantly higher in patients with endometriosis (P < 0.001). Conclusions Ocular surface changes, including squamous metaplasia, may be observed in the conjunctiva of patients with endometriosis. Keywords Endometriosis . Conjunctival impression cytology . Dry eye . Schirmer I test . Tear breakup time
Introduction Endometriosis is a common gynecological disease characterized by localization of endometrial tissues outside the uterine cavity [1]. This chronic inflammatory disease occurs in 6– 10% of women at a reproductive age [2]. Endometriosis, which frequently causes chronic pelvic pain and infertility, can significantly reduce the quality of life of women [3, 4]. It can also directly or indirectly affect other tissues and organs, such as the breast, thyroid, and bladder [5, 6]. Endometriosis
* Meydan Turan [email protected] 1
Department of Ophthalmology, Balikesir Ataturk City Hospital, Balikesir, Turkey
2
Faculty of Medicine, Department of Pathology, Balıkesir University, Balıkesir, Turkey
3
Faculty of Medicine, Department of Obstetrics and Gynecology, Balikesir University, Balikesir, Turkey
is considered to be an estrogen-dependent disease, although its etiology has not been fully elucidated [7]. The role of estrogen in the dry eye remains unclear. The differences in serum estrogen levels and their effects on different tissues of the eye surface are not clear. Previous studies suggest that estrogen inhibits the secretion of the meibomian gland, which in turn may cause inflammation [8, 9]. Conjunctival impression cytology (CIC) is a safe, noninvasive method used to assess changes in the cellular level in the c
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