Conjunctival Autofluorescence and Cytological Changes in Pterygium

Abstract

The purpose of this study was to evaluate the presence and pattern of autofluorescence and its related cytological changes in pterygium. Eighty-six patients with unilateral pterygium and 76 controls were recruited. We graded pterygium, looked for autofluorescence, performed cytology of the nasal conjunctiva, repeated evaluation after 6 months, compared findings with controls, and assessed the progression of pterygium from photographs with the help of ImageJ software. Autofluorescence was present in 51% of cases with pterygium. Autofluorescence at the leading edge (65.9%) was the predominant pattern seen. In total, 83.3% of grade 3 pterygia, 64.7% of grade 2 pterygia, and 28.9% of grade 1 pterygia (P value <0.0005) had autofluorescence. Impression cytology showed conjunctival epithelial cells in 60% of cases, significant squamous metaplasia in grade 3 pterygia (45%) compared with grade 2 pterygia (11.8%), and normal conjunctival epithelial cells in grade 1 pterygia (P value < 0.0005). The presence and pattern of conjunctival autofluorescence and cytological changes, especially squamous metaplasia, are linked to the severity or grade of pterygium.