Abstract
The topical administration of rebamipide (Mucosta®), an antiulcer agent, clinically increases the mucin level of tear film. The aim of this study was to report the histological changes of goblet cells following the topical administration of rebamipide to a patient with nevus of the lacrimal caruncle. A 62-year-old male exhibited a pigmented nodule located in the lacrimal caruncle in the left eye. An excisional biopsy and subsequent surgical resection were conducted at the caruncle, prior to and three months after topical rebamipide administration. Histologically, a biopsy specimen revealed a pigmented nevus beneath the caruncle epithelium containing a few goblet cells [4 cells/high power field (HPF)]. A few nevus cells were present at the surgical margin. By contrast, the secondary resected specimen obtained three months after the initiation of topical rebamipide treatment revealed the epithelium and nevus, where numerous goblet cells were present (28 cells/HPF), and mucin-like substances were markedly secreted from the goblet cells. Topical rebamipide markedly increased the number of goblet cells and stimulated the secretion of mucin-like substances in the caruncular tissue of a human patient. These results suggest that topical rebamipide is useful in patients following surgery and/or biopsy to support tissue repair of the ocular surface.
Highlights
Goblet cells synthesize, store and secrete a complex of high‐molecular-weight glycoproteins
To the best of our knowledge, the present study describes the first case of nevus in the lacrimal caruncle showing a marked increase in goblet cell number and secretion of mucin-like substances following the administration of topical rebamipide
We recently demonstrated that rebamipide clearly influenced mucosal goblet cells in human conjunctival tissue [7], which verified in vitro evidence that rebamipide led to an elevation of the number of goblet cells in rat conjunctiva [4,5]
Summary
Store and secrete a complex of high‐molecular-weight glycoproteins. Mucins, included in the glycoproteins, are essential for the maintenance of a normal precorneal tear film and healthy ocular surface [1]. A 62-year-old male complained of enlargement of a pigmented lesion in the left eye. The visual acuity of the patient was 1.0 for the left eye with normal intraocular pressure. Since there were pigmented nevus cells beneath the epithelium without cellular atypia (Fig. 1A), the tumor was diagnosed as pigmented nevus. Mucin-like substances were not observed on the epithelium (Fig. 1B). The patient underwent treatment with topical rebamipide eye drops four times a day for three months without any other topical agents to support wound healing of the ocular surface. Slit‐lamp examination demonstrated a tiny pigmented lesion of the left eye (Fig. 2A) three months after the start of rebamipide treatment.
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