Conjunctival goblet cells and mitotic rate in children with retinol deficiency and measles
V. Rao, J. Friend, R. A. Thoft, B. A. Underwood and P. R. Reddy
To study the effect of retinol deficiency and measles on the conjunctival
epithelium, we determined the epithelial mitotic rate (MR) and goblet cell
frequency (GCF) in conjunctival biopsy specimens from preschool children in
Hyderabad, India. We studied three groups of children: normal appearing,
clinically retinol deficient (defined by the presence of superficial fine
punctate keratitis), and clinically retinol deficient with measles. The
last group was subdivided into those with low serum retinol levels (less
than or equal to 20 micrograms/dL [less than or equal to mumol/L]) and
those with normal serum retinol levels (greater than 20 micrograms/dL
[greater than 0.70 mumol/L]). In the control group of seven
normal-appearing children with a mean age of 4.6 years, the mean MR was
1.3% +/- 0.4%, and the mean GCF was 8.0% +/- 3.6% of the basal epithelial
cells. In seven children with clinical retinol deficiency, the mean MR was
15.4% +/- 1.2%, and the mean GCF was 1.0% +/- 0.5%, values significantly
different from normal ones. Among 11 children with clinical retinol
deficiency, measles, and low serum retinol levels, the mean MR was 9.0% +/-
1.9%, and the mean GCF was 3.1% +/- 1.1%, values not statistically
different from those in children with clinical retinol deficiency alone.
Five children with clinical retinol deficiency, measles, and normal serum
retinol levels had a mean MR of 10.2% +/- 3.7% and a mean GCF of 1.9% +/-
1.7%, values similar to those in the other disease groups. This indicates
that retinol deficiency sufficient to cause clinical signs without
subepithelial scarring or keratinization is associated with
hyperproliferation of the conjunctiva whether or not there is a
superimposed measles infection.
