A Study in the Examination of the Pathogenesis of Pterygium
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2014-01-15
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University of Hawaii at Manoa
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Pterygium is of unknown etiology and pathogenesis. It is a conjunctival disease that has a tendency to invade the cornea. Pterygium occurs as a fleshy, triangular growth usually on the nasal side of the bulbar conjunctiva (1). Covered by an epithelium of the conjunctival type, it is a vascular structure consisting of blood vessels and loose fibrous connective tissue (2). Pterygium is essentially not harmful. However, it is removed surgically when it enlarges or invades the pupillary area. Although the growth is benign, recurrence of the disease is not uncommon, with recurrence rates of 20-30% (3). In order to prevent regrowth, postoperative measures, such as strontium-90 beta irradiation (3) and administration of thio-TEPA (triethylmethiophosphamide) (4), are employed. Both have been proven safe and effective, lowering the chance of recurrence to 10% or less (3, 4). Pterygium is most prevalent in tropical and subtropical countries, between 37°N and 37°S latitude (5). Thus, prolonged exposure to ultraviolet light has been suggested to cause the disease. Solar radiation is believed to damage the corneal epithelium, Bowman's membrane, and conjunctiva, and to dry the tear film (2). Other exogenous factors implicated are dust and wind. Studies also suggest a hereditary predisposition to pterygium. The heredity trait, believed to be of a dominant mode with variable penetrance, is manifested only when exogenous factors, such as U.V. radiation and dust, are present (6,7). Few studies have been made on the pathogenesis of pterygium. The objective of this study was to determine the contribution of an immunological process in the pathogenesis of pterygium. For this purpose, surgically excised pterygia1 tissues were examined for immunoglobulins by immunofluorescence procedures.
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12 pages
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