Quantitative evaluation of ocular surface inflammation in patients with different grade of conjunctivochalasis

Curr Eye Res. 2010 Aug;35(8):665-9. doi: 10.3109/02713681003770738.


Purpose: To evaluate and compare HLA-DR expression of conjunctival epithelial cells in different grade of conjunctivochalasis (CCh).

Patients and methods: Thirty patients and seven healthy subjects underwent clinical examination, grading of CCh by lid-parallel conjunctival fold (LIPCOF) test, and impression cytology of the bulbar conjunctiva. HLA-DR expression was analyzed by flow cytometry. Schirmer test, tear break-up time, and vital staining were also performed.

Results: Patients who presented with mild and moderate CCh showed a similar expression of HLA-DR to normal subjects. A significant increase (p < 0.005) of HLA-DR was found in patients with severe CCh. Positive correlation was found between fluorescein staining and HLA-DR expression (r = 0.36, p = 0.009) and between lissamine-green staining and HLA-DR expression (r = 0.30, p = 0.027). Neither correlation was found between Schirmer test nor break up time and HLA-DR expression.

Conclusion: Inflammation plays a pivotal role on the ocular surface of patients with severe CCh. Since mild and moderate CCh HLA-DR expression was similar to normal controls, we can speculate that the source of inflammation could be the presence of conjunctival folds.

MeSH terms

  • Biomarkers / metabolism
  • Coloring Agents / metabolism
  • Conjunctiva / metabolism*
  • Conjunctiva / pathology
  • Conjunctival Diseases / classification
  • Conjunctival Diseases / metabolism*
  • Conjunctival Diseases / pathology
  • Epithelial Cells / metabolism*
  • Epithelial Cells / pathology
  • Female
  • Flow Cytometry
  • HLA-DR Antigens / metabolism*
  • Humans
  • Inflammation / metabolism
  • Lissamine Green Dyes / metabolism
  • Male
  • Middle Aged
  • Staining and Labeling


  • Biomarkers
  • Coloring Agents
  • HLA-DR Antigens
  • Lissamine Green Dyes