Assessment of Conjunctival Surface Changes in Post COVID Patients by Impression Cytology

Abstract

Abstract Background The conjunctiva is a transparent, clear, thin membrane that covers part of the eye’s front surface and the inner surface of the eyelids. It is divided into three regions: the palpebral or tarsal conjunctiva, the bulbar or ocular conjunctiva, and the conjunctival fornices. The novel coronavirus (COVID-19), named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first identified in December 2019 after a series of acute atypical lung disease cases occurred in Wuhan, China. Aim of the Work The aim of the our study is assessment of the inflammatory and neoplastic changes that happened on the ocular surface especially the conjunctiva according to Nelson staging system in post-COVID-19 patients and evaluated by impression cytology. Patients and Methods This study was conducted on a selected sample of patients attending the Ophthalmology outpatient clinic of Ain Shams University Hospitals in Cairo, specimens of impression cytology were stained and examined in the Pathology department of Ain Shams University. Results In the present study, comparison between cases and controls groups as regards epithelial cells showed that in cases group there was normal, small, round cells in 19(59.4%) cases, slightly larger, more polygonal cell in 11(34.4%), and Larger, polygonal cells in 2(6.3%), and in controls group, there was normal, small, round cells in 25(78.1%) cases, slightly larger, more polygonal cell in 7(21.9%), there was no statistically significant difference between the two groups as regards epithelial cells (p > 0.05). Furthermore, As regards N/C ratio where in cases group the ratio was 1:2 in 19(59.4%) cases, 1:3 in 11(34.4%), and 1:4-1:5 in 2(6.3%), and in controls group, it was 1:2 in 25(78.1%) cases, 1:3 in 7(21.9%), there was no statistically significant difference between the two groups as regards N/C ratio. In the current study, as regards Keratinization where 6(18.8%) cases had mild keratinization in cases group in comparison to 2(6.3%) cases in controls group. There was no statistically significant difference between the two groups as regards Keratinization (p > 0.05). Moreover, we found that there was no dysplasia in both cases and controls groups. The comparison between cases and controls groups as regard Goblet cells where in cases group the goblet cells was stage 0 in 17(53.1%) cases, others was stage 1 in 13(40.6%), and the cells was stage 2 in 2(6.3%), and in controls group, there was stage 0 cells in 22(68.8%) cases, stage 1 in 10(31.3%), there was no statistically significant difference between the two groups as regard goblet cells density. Conclusion There is non significant inflammatory or neoplastic changes that have been occurred in conjunctival surface in post-COVID-19 patients. Except for lymphocytes infiltration.