QURUQ KO’Z SINDROMI VA ATROFIK RINIT BO’LGAN BEMORLARDA KON’YUNKTIVANING MORFOLOGIK O’ZGARISHLARI
Abstract
Relevance. Dry eye disease (DED) is associated with tear film instability and structural alterations of the conjunctival epithelium. Loss of goblet cells and epithelial metaplasia play a key role in disease progression. Concomitant atrophic rhinitis may aggravate these pathological changes. Purpose of the study. To evaluate morphological and morphometric alterations of the conjunctival epithelium in patients with dry eye disease and in those with dry eye disease associated with atrophic rhinitis using impression cytology. Material and methods. The study included 98 patients examined over a six-month period. Three groups were formed: control group (n=17), patients with isolated DED (n=55), and patients with DED combined with atrophic rhinitis (n=26). All participants underwent OSDI questionnaire assessment, Schirmer test, tear break-up time (TBUT), and meibography. Conjunctival morphology was evaluated using impression cytology. Morphometric analysis (nuclear area, cytoplasmic area, and nuclear-to-cytoplasmic ratio) was performed using QuPath 5.0.0 software. Statistical significance was considered at p<0.05. Results and conclusions. Patients with DED demonstrated a significant reduction in nuclear and cytoplasmic areas of intermediate epithelial cells, decreased goblet cell size and density, and features of epithelial metaplasia. In the combined pathology group, these alterations were more pronounced, with marked epithelialatrophy and increased nuclear-to-cytoplasmic ratio. Reduced goblet cell parameters indicated mucin deficiency and tear film instability. Impression cytology is a highly informative and minimally invasive method for assessing conjunctival alterations in DED. The coexistence of DED and atrophic rhinitis leads to more severe epithelial damage, highlighting the importance of considering upper airway comorbidity in patient management.