Highlights
- •Provides the first objective analysis of confocal assessments of conjunctival goblet cells.
- •Analyses reveal notable differences between studies that need to be addressed.
- •Differences between studies appear to be uniquely dependent on the strategies used for image selection.
Abstract
Background
In vivo confocal microscopy (IVCM) has been used for over 10 years to assess the goblet cell
density (GCD) within the human conjunctiva, but the reported values have been variable
with no obvious indications as to why.
Methods
From publications between 2008 and 2019, representative GCD values were extracted,
as well as on the image sampling strategy used.
Results
Average GCD values for any particular group of individuals ranged from 7 to 979 goblet
cells / sq. mm, and with one notable outlier removed, an overall group-mean value
for GCD (+/− SD) from single site locations was 207 +/− 143 goblet cells / sq. mm
from 15 data sets for those usually designated as control subjects, with a value of
190 +/− 161 goblet cells / sq. mm calculated from 20 single site data sets from other
(patient) groups. An overall analysis indicated that the reported average values for
GCD from different groups of individuals increased according to the number of images
assessed / individual (Spearman rho = 0.304), on the number of individuals evaluated
to generate an averaged value for each group (rho = 0.367), and the total number of
images assessed (rho = 0.346, multivariate analysis partial r = greater or = to 0.522).
Conclusions
In the use of confocal microscopy to assess the number of goblet cells in the human
bulbar conjunctiva, the substantial differences reported appear to be linked to the
protocols used for image selection, and some type of standardization needs to be developed.
Keywords
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Article info
Publication history
Published online: January 15, 2020
Accepted:
January 5,
2020
Received in revised form:
December 15,
2019
Received:
July 21,
2019
Identification
Copyright
Crown Copyright © 2020 Published by Elsevier Ltd on behalf of British Contact Lens Association. All rights reserved.
