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The use of impression cytology in the follow-up of severe ocular burns
  1. Jean-Jacques Gicquel1,
  2. Renaud Navarre1,
  3. Maria Elena Langman1,
  4. Alix Coulon2,
  5. Stephanie Balayre1,
  6. Serge Milin2,
  7. Martial Mercie1,
  8. Alexis Rossignol3,
  9. Anne Barra3,
  10. Pierre-Marie Levillain2,
  11. Jean-Marc Gombert3,
  12. Paul Dighiero1
  1. 1
    Department of Ophthalmology, Poitiers University Hospital, 2 rue de la Milétrie, BP 577–86021, Poitiers, France
  2. 2
    Department of Pathology, Poitiers University Hospital, 2 rue de la Milétrie, BP 577–86021, Poitiers, France
  3. 3
    Department of Immunology, Poitiers University Hospital, 2 rue de la Milétrie, BP 577–86021, Poitiers, France
  1. P Dighiero, Department Head of Ophthalmology, C.H.U. Jean Bernard, 2 rue de la Milétrie, BP 577–86021, Poitiers, France; p.dighiero{at}


Aims: To evaluate by impression cytology (IC) the expression of the MHC class II inflammatory marker HLA-DR by the conjunctival epithelium, the cytological modifications of the conjunctival surface according to the Nelson’s classification, and the eventual correlation between the two after severe ocular burns.

Methods: A total of 24 patients (24 eyes) who presented with severe ocular burns underwent IC. We compared them with 18 healthy eyes. HLA-DR expression was studied by flow cytometry as well as the conjunctival histology evaluated with the Nelson’s classification from 2–24 months after the onset of burns.

Results: There was a significant upregulation of the expression of HLA-DR in eyes with burns compared to the healthy population at 2 months (p<0.001), 6 months (p<0.001), 12 months (p = 0.019), 18 months (p = 0.0171) and 24 months (p = 0.01766). A significant difference was found between the Nelson grade in the pathological population and those of the healthy population at 2 months (p = 0.0157). HLA-DR upregulation was significantly correlated with the Nelson’s grades between 2 months (r = 0.69, p<0.0001) and 6 months (r = 0.61, p = 0.0001).

Conclusion: The IC technique can act as a useful tool for following-up ocular surface inflammation after severe ocular burns.

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  • Competing interests: None.

  • This prospective study adhered to the tenets of the Declaration of Helsinki. Approval was obtained from the Institutional Review Board of the University of Poitiers, Jean Bernard University Hospital, Poitiers, France and an informed consent was signed by every patient included in this study, according to French regulations. None of the authors have any commercial interest in the products that are mentioned in this manuscript.

  • Abbreviations:

    fluorescein isothiocyanate


    impression cytology


    limbal stem cell deficiency


    periodic acid Schiff