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Identifier	000442899
Title	Μη επεμβατική ανίχνευση ανθρώπινου ιού των θηλωμάτων σε ιστούς οφθαλμικού πτερυγίου : Κλινικο-επιδημιολογικές συσχετίσεις
Alternative Title	Non-invasive detection of human papillomavirus (HPV) in specimens of ophthalmic pterygium
Author	Χαλκιά, Αικατερίνη
Thesis advisor	Δετοράκης, Ευστάθιος
Reviewer	Σουρβίνος, Γεώργιος Ζαφειρόπουλος, Αλέξανδρος Τσιλιμπάρης, Μιλτιάδης Σιγανός, Χαράλαμπος Χαμηλός, Γεώργιος Χλουβεράκης, Γρηγόρης
Abstract	Ophthalmic pterygium represents a chronic, triangle-shaped, fibrovascular lesion, that expands from the limbal stem cells towards the bulbar conjunctiva and the cornea. Its gradual expansion may be sight-threatening. Pterygium development has been correlated to chronic UV exposure, however, although pterygium has been extensively studied, its pathogenesis remains unclear. In the past, it has been considered a degenerative disease, but recent studies, that identified molecular genetic alterations, alterations in tumor suppression genes and presence of oncogenic viruses, such as Human papillomavirus (HPV), in pterygia, indicated a possible neoplastic nature of the disease. HPV has been correlated with conjunctival papillomas and ocular surface squamous neoplasia of the conjunctiva. Many studies have identified HPV in ophthalmic pterygia. However, there is discordance regarding the prevalence of the virus in the different studies, that may be due to geographical differences and variability in the virus identification methods. In the present thesis, the evaluation of the use of swab samples, a minimally invasive diagnostic technique for the identification of HPV, in 40 patients with ophthalmic pterygium, compared with respective tissue specimens was studied. For the identification and genotyping of 14 high and intermediate risk HPV types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68) real time PCR analysis was conducted. Moreover, 40 patients with normal conjunctiva were included in our study as control group. Patients with no recurrence had an 1-year post-surgical follow up. The analysis of our results revealed the presence of HPV in 11 tissue specimens and in 9 swab samples. The HPV subtypes detected were 33, 39, 45, 56, 59, 66, 68. The swab test had 81.82% sensitivity and 100% specificity. Thirty-five patients with pterygium completed the 12-months follow up. In 15 (43%) of them, pterygium removal was performed with bare sclera excision and twenty patients underwent surgical excision with use of autologous conjunctival graft. The analysis of the results revealed a correlation of the size of pterygium and the type of surgery with disease relapse. Lastly, patients with disease recurrence had more probabilities to be HPV+, whereas in HPV+ pterygium patients with no recurrence, the virus was not detected one year after surgery. As for the patients with normal conjunctiva, the virus was not detected in 37 of them, whereas in 3 patients the quantity of the sample was not adequate for analysis. Our findings indicate that the use of swab samples and real time PCR analysis may be a valuable tool for HPV detection in ophthalmic pterygium and may offer a better understanding of its pathogenetic mechanism and recurrence.
Language	Greek
Subject	Υποτροπή
Issue date	2021-12-01
Collection	School/Department--School of Medicine--Department of Medicine--Doctoral theses
	Type of Work--Doctoral theses
Permanent Link	https://elocus.lib.uoc.gr//dlib/9/a/2/metadata-dlib-1634286571-912129-7610.tkl
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