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Year : 2014  |  Volume : 27  |  Issue : 2  |  Page : 386-394

Clinical, pathological, and molecular aspects of recurrent versus primary pterygium

1 Department of Ophthalmology, Faculty of Medicine, Menoufia University, Shebin El-Kom, Menoufia, Egypt
2 Department of Pathology, National Liver Institute, Menoufia University, Shebin El-Kom, Menoufia, Egypt

Correspondence Address:
Ahmed M Shebl
MBBCh, Department of Ophthalmology, Faculty of Medicine, Menoufia University, Shebin El-Kom, Menoufia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1110-2098.141713

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Objectives The objective of this study was to evaluate the clinical aspects of primary and recurrent pterygia and correlate them with the histopathological, immunohistochemical, and molecular characteristics of the pterygial sections. Background Pterygium is a fibrovascular, usually triangular membrane that begins growing from limbal epithelium and advances on the corneal surface, characterized by degenerative and hyperplastic changes in the conjunctival epithelium, proliferative and inflammatory characteristics, and a rich vasculature. The pathogenesis of pterygium is still incompletely understood. Ultraviolet irradiation is believed to be the most important factor in its development. Materials and methods This study included 44 pterygium patients who underwent pterygium excision by the bare sclera procedure. The tissues obtained were subjected to a histopathological examination as well as an immunohistochemical analysis for phospho-P53 and ki-67 and PCR for the human papillomavirus (HPV). Results Histopathological findings included epithelial and stromal inflammation, vascular proliferation, fibrosis, and solar elastosis. Epithelial dysplasia was detected in 43.6% of the specimens. The phospho-P53-positive rate was 96.2% and the ki-67-positive rate was 96.3%. HPV DNA was not detected in any of the pterygial specimens. Conclusion The high frequency of epithelial dysplasia supports the neoplastic theory of pterygium pathogenesis. Phospho-p53 expression is increased in pterygial epithelium as well as ki-67, which indicates the high proliferative activity. The absence of HPV suggests that it is not an etiological factor for pterygium pathogenesis in Egypt.

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