Cargando…

Classification of Lacrimal Punctal Stenosis and Its Related Histopathological Feature in Patients with Epiphora

PURPOSE: To evaluate the classification of punctal stenosis based on the shape of the external punctum, clinical characteristics and histopathologic features. METHODS: Patients who experienced tearing and were diagnosed with punctal stenosis were evaluated in this study. Punctal stenosis was classif...

Descripción completa

Detalles Bibliográficos
Autores principales: Hur, Mun Chong, Jin, Sang Wook, Roh, Mi Sook, Jeong, Woo Jin, Ryu, Won Yeol, Kwon, Yoon Hyung, Ahn, Hee Bae
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Ophthalmological Society 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5636712/
https://www.ncbi.nlm.nih.gov/pubmed/28994268
http://dx.doi.org/10.3341/kjo.2016.0129
_version_ 1783270495808913408
author Hur, Mun Chong
Jin, Sang Wook
Roh, Mi Sook
Jeong, Woo Jin
Ryu, Won Yeol
Kwon, Yoon Hyung
Ahn, Hee Bae
author_facet Hur, Mun Chong
Jin, Sang Wook
Roh, Mi Sook
Jeong, Woo Jin
Ryu, Won Yeol
Kwon, Yoon Hyung
Ahn, Hee Bae
author_sort Hur, Mun Chong
collection PubMed
description PURPOSE: To evaluate the classification of punctal stenosis based on the shape of the external punctum, clinical characteristics and histopathologic features. METHODS: Patients who experienced tearing and were diagnosed with punctal stenosis were evaluated in this study. Punctal stenosis was classified according to the shape of the lower external punctum, which included membranous type, slit type, horseshoe type, and pinpoint type. Tear meniscus height, 2% fluorescein dye disappearance test and lacrimal pathway irrigation were measured or performed. For treatment, a punctal snip operation and silicone tube placement were performed, and the peripunctal histopathological findings were evaluated. RESULTS: Punctal stenosis was classified into four types: membranous type (17 eyes, 21.5%), slit type (11 eyes, 13.9%), horseshoe type (25 eyes, 31.6%), and pinpoint type (26 eyes, 32.9%). The tear meniscus was significantly higher, and the 2% fluorescein dye disappeared significantly more slowly in the punctal stenosis group. However, correlation of the tear meniscus height and 2% fluorescein dye disappearance test with the punctum shape was not statistically significant. A history of previous chemotherapy was significantly associated with the occurrence of punctal stenosis, especially the membranous type (p < 0.05). Histopathologic evaluation of the punctum showed differences between the punctum types. Pinpoint puncta exhibited a high density of muscle fibers, while they were faintly visible in the membranous type. CONCLUSIONS: Acquired punctal stenosis has various shapes, and the major types of stenotic puncta exhibited unique histopathologic features. Punctal stenosis and its pathophysiology may be related to multiple factors, such as age and systemic 5-fluorouracil chemotherapy history.
format Online
Article
Text
id pubmed-5636712
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher The Korean Ophthalmological Society
record_format MEDLINE/PubMed
spelling pubmed-56367122017-10-12 Classification of Lacrimal Punctal Stenosis and Its Related Histopathological Feature in Patients with Epiphora Hur, Mun Chong Jin, Sang Wook Roh, Mi Sook Jeong, Woo Jin Ryu, Won Yeol Kwon, Yoon Hyung Ahn, Hee Bae Korean J Ophthalmol Original Article PURPOSE: To evaluate the classification of punctal stenosis based on the shape of the external punctum, clinical characteristics and histopathologic features. METHODS: Patients who experienced tearing and were diagnosed with punctal stenosis were evaluated in this study. Punctal stenosis was classified according to the shape of the lower external punctum, which included membranous type, slit type, horseshoe type, and pinpoint type. Tear meniscus height, 2% fluorescein dye disappearance test and lacrimal pathway irrigation were measured or performed. For treatment, a punctal snip operation and silicone tube placement were performed, and the peripunctal histopathological findings were evaluated. RESULTS: Punctal stenosis was classified into four types: membranous type (17 eyes, 21.5%), slit type (11 eyes, 13.9%), horseshoe type (25 eyes, 31.6%), and pinpoint type (26 eyes, 32.9%). The tear meniscus was significantly higher, and the 2% fluorescein dye disappeared significantly more slowly in the punctal stenosis group. However, correlation of the tear meniscus height and 2% fluorescein dye disappearance test with the punctum shape was not statistically significant. A history of previous chemotherapy was significantly associated with the occurrence of punctal stenosis, especially the membranous type (p < 0.05). Histopathologic evaluation of the punctum showed differences between the punctum types. Pinpoint puncta exhibited a high density of muscle fibers, while they were faintly visible in the membranous type. CONCLUSIONS: Acquired punctal stenosis has various shapes, and the major types of stenotic puncta exhibited unique histopathologic features. Punctal stenosis and its pathophysiology may be related to multiple factors, such as age and systemic 5-fluorouracil chemotherapy history. The Korean Ophthalmological Society 2017-10 2017-09-25 /pmc/articles/PMC5636712/ /pubmed/28994268 http://dx.doi.org/10.3341/kjo.2016.0129 Text en © 2017 The Korean Ophthalmological Society http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Hur, Mun Chong
Jin, Sang Wook
Roh, Mi Sook
Jeong, Woo Jin
Ryu, Won Yeol
Kwon, Yoon Hyung
Ahn, Hee Bae
Classification of Lacrimal Punctal Stenosis and Its Related Histopathological Feature in Patients with Epiphora
title Classification of Lacrimal Punctal Stenosis and Its Related Histopathological Feature in Patients with Epiphora
title_full Classification of Lacrimal Punctal Stenosis and Its Related Histopathological Feature in Patients with Epiphora
title_fullStr Classification of Lacrimal Punctal Stenosis and Its Related Histopathological Feature in Patients with Epiphora
title_full_unstemmed Classification of Lacrimal Punctal Stenosis and Its Related Histopathological Feature in Patients with Epiphora
title_short Classification of Lacrimal Punctal Stenosis and Its Related Histopathological Feature in Patients with Epiphora
title_sort classification of lacrimal punctal stenosis and its related histopathological feature in patients with epiphora
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5636712/
https://www.ncbi.nlm.nih.gov/pubmed/28994268
http://dx.doi.org/10.3341/kjo.2016.0129
work_keys_str_mv AT hurmunchong classificationoflacrimalpunctalstenosisanditsrelatedhistopathologicalfeatureinpatientswithepiphora
AT jinsangwook classificationoflacrimalpunctalstenosisanditsrelatedhistopathologicalfeatureinpatientswithepiphora
AT rohmisook classificationoflacrimalpunctalstenosisanditsrelatedhistopathologicalfeatureinpatientswithepiphora
AT jeongwoojin classificationoflacrimalpunctalstenosisanditsrelatedhistopathologicalfeatureinpatientswithepiphora
AT ryuwonyeol classificationoflacrimalpunctalstenosisanditsrelatedhistopathologicalfeatureinpatientswithepiphora
AT kwonyoonhyung classificationoflacrimalpunctalstenosisanditsrelatedhistopathologicalfeatureinpatientswithepiphora
AT ahnheebae classificationoflacrimalpunctalstenosisanditsrelatedhistopathologicalfeatureinpatientswithepiphora