Impression cytology (IC) has been widely used as a method for evaluating the ocular surface and superficial cells layers in the diagnosis and follow-up after treatment of several ocular surface tumors of both epithelial and melanocytic origin. Information regarding this can be found in the English-language literature since 1992. Using either cellulose acetate or Biopore membranes for specimen collection, a high correlation has been found between IC and tissue histology. Compared with exfoliative cytology with spatula, IC is less traumatic to the patient's eye, provides a precise location of the area being studied, and allows accurate observation of the cells the way they exist in vivo. The additional advantage of IC is the preservation of limbal stem cells responsible for continuous corneal epithelium renewal; these can be affected after incisional or excisional biopsy at the corneoscleral limbus, which is the most frequent site of appearance of tumors in the stratified epithelium. Treatment for ocular surface squamous neoplasia has historically included surgery, but nonsurgical interventions have also been adopted. Hence, in certain cases, ophthalmologists may prefer interventions less invasive than surgical biopsy such as of impression cytology for both initial diagnosis and therapeutic monitoring of treatment for ocular surface lesions. Nevertheless, it should be considered that IC may be less helpful if the results conflict with the clinical picture or if the clinical diagnosis is uncertain and results are negative. In such cases, surgical biopsy is required for accurate diagnosis. The purpose of this review is to examine the published literature on the utilization of IC for the diagnosis and management of ocular surface tumors and to discuss the requirement for further investigation on the subject.
INTRODUÇÃONo Brasil há registro de 110.000 a 120.000 casos novos/ano de tuberculose sendo que a região norte apresenta a maior prevalência nacional (1) . São fatores de risco para tuberculose: raça (não branca), sexo (masculino), idade (crianças e idosos), nível socioeconômico (baixo), doenças sistêmicas (diabetes melitus, tumores, alcoolismo, AIDS, silicose) (2) . A tuberculose ocular é encontrada em 1 a 2% dos pacientes com doença pulmonar (1,3) e pode comprometer todas as estruturas oculares e seus anexos por ação direta da agente que, a partir de infecção inalatória e posterior disseminação linfo-hematogênica, acometem órgãos extrapulmonares ou por reação imunológica de hipersensibilidade do tipo IV.As alterações mais freqüentemente causadas por ação direta do patóge-no são o tuberculoma de anexos, conjuntiva, íris e coróide; as uveítes anteriores e posteriores; e a endoftalmite. A presença de flictênulas na conjuntiva ou córnea e de vasculite retiniana ocorrem devido à reação de hipersensibilidade tipo IV.Devido a dificuldade em se isolar o agente na tuberculose ocular o diagnóstico é presuntivo na maioria dos casos, considerando para tanto a epidemiologia positiva, a clínica (sistêmica e ocular) e a resposta imunológi-ca do paciente.Este estudo foi realizado com o objetivo de estudar as alterações ocula- Alterações oculares em pacientes com tuberculose
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