Cartography of Impression Cytology

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Abstract
Impression cytology is a minimally invasive diagnostic procedure allowing the collection of a monolayer of cells from the conjunctival surface. Both light and electron microscopy study of individual cellular changes, as well as the analysis of two-dimensional ocular surface changes, can be evaluated. Its most widespread application is for the detection and grading of squamous metaplasia. Grades for the morphological changes of squamous metaplasia have been described. We have developed a regional mapping technique that records the distribution of the various grades over the ocular surface areas sampled. This technique may offer greater sensitivity to variations in the distribution of squamous metaplasia in response to disease or therapy. SUMMARY The cartography of IC is useful in identifying the distribution of squamous metaplasia across conjunctival surfaces. The IC map may allow more specific measurements of the adverse effects of medications and preservatives, as well as the beneficial effects of tear supplements and new biological molecules such as vitamin A and fibronectin. The use of punctate keratitis, Schirmer's testing, and tear breakup time are relatively gross and imprecise measurements of the changes occurring to the end tissue, the conjunctiva (13–15). Previous work with IC has been valuable in refining the technique of collection and staining, as well as in establishing the grades of squamous metaplasia. Cartography offers the added benefit of greater sensitivity to surface changes.

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