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Article
September 1989

Ocular Surface Keratinization as a Predictor of Response to Topical Retinoic Acid Therapy

Author Affiliations

San Francisco, Calif

Arch Ophthalmol. 1989;107(9):1275-1276. doi:10.1001/archopht.1989.01070020345002
Abstract

To the Editor.  —Retinoic acid has improved clinical signs in most cicatrizing dry eye conditions, but not in keratoconjunctivitis sicca.1 Even in the absence of cicatrization, it has produced a substantial improvement in some cases of conjunctival and corneal keratinization.2 We found that ocular surface keratinization was predictive of response to topical retinoic acid treatment in the course of a randomized, double-masked, placebo-controlled, crossover trial.We quantified conjunctival and corneal keratinization by dividing the ocular surface into 11 zones and scored each area from 0 (no keratinization) to 3 (thick keratin plaque), based on slit-lamp examination and rose bengal staining. The numbers were added to determine a total clinical keratinization score. Conjunctival scrapings were Giemsa stained; an average of 200 to 300 epithelial cells were randomly counted from areas of each slide to determine the percentage of keratinized cells and keratinizing epithelial cells.

Report of a Case.  —A

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