Cytologic changes seen in conjunctival cells from the eye of a patient may provide supportive evidence for the diagnosis of vitamin A deficiency. Makdani et al used a grading scheme for reporting these changes. The authors are from Lincoln University, CDC, Ramsey Clinic, Belize Vision Center and the Beltsville Human Nutrition Research Center.
Method: Conjunctival Impression Cytology with Transfer (CICT)
Parameters:
(1) epithelial cell size
(2) epithelial cell cytoplasm
(3) epithelial nuclear-to-cytoplasmic ratio
(4) number of goblet cells
(5) goblet cell features
|
Grade 0 |
Grade 1 |
Grade 2 |
Grade 3 |
epithelial cell size |
small, round |
slightly larger, more polygonal |
larger, polygonal |
large and polygonal |
epithelial cell cytoplasm |
eosinophilic staining |
eosinophilic staining |
variable staining |
basophilic staining |
epithelial cell N:C ratio |
1:2 |
1:3 |
1:4 - 1:6 |
> 1:6 |
number of goblet cells |
abundant |
decreased |
markedly decreased |
very few or none |
features of goblet cells |
plump, oval, cytoplasm intense PAS+ |
plump, oval, cytoplasm intense PAS+ |
smaller, poorly defined cell border, less intense PAS |
|
score for patient =
= ((grade for left eye) + (grade for right eye)) / 2
where:
• The scores for both eyes are supposedly closely correlated. I would think this means that the scores for both sides are +/- 1 grade.
Interpretation:
• minimum score: 0
• maximum score: 3
• A score < 1.5 is considered normal (since the values are whole numbers, this could be stated also as <= 1).
• A score >= 1.5 is considered abnormal (operationally this would be a score of >= 2 in at least 1 eye).
Specialty: Ophthalmology, Nutrition
ICD-10: ,