Histopathological Differences Between Atrophic and Progressive Primary Pterygium: A Clinicopathological Correlation Study.

Original Article

Abstract

Objective: To compare the histopathological features of atrophic and progressive primary pterygium.

Methodology: This Correlational study was conducted in the Department of Anatomy, Rawalpindi Medical University, Rawalpindi, Pakistan, from January 2020 to January 2021. we collected clinical data and pterygium specimens. Out of 41 primary pterygium specimens,31 were clinically atrophic, and 10 were progressive. We processed excised tissue for light microscopy. Histological assessment included basement membrane fragmentation and delayering, epithelial separation, epithelial fragmentation, epithelial invagination, goblet-cell pattern, stromal inflammatory infiltration, and elastosis. We used Fisher's exact test for binary findings and the Mann-Whitney U test for ordinal histological grades. We considered p-values below 0.05 significant.

Results: Basement membrane fragmentation was present in 93.5% of atrophic and 100% of progressive lesions. Basement membrane delayering was present in 80.6% and 80.0%, respectively. Epithelial fragmentation was found in 90.3% of atrophic and all progressive lesions, while epithelial invagination was seen in 96.8% of atrophic and 80.0% of progressive lesions. Diffuse inflammatory infiltration was present in about 90% of both groups. High-grade elastosis (>10%) was present in 77.4% of atrophic and 80.0% of progressive lesions. No statistically significant differences were detected for the measured histopathological features.

Conclusion: Atrophic and progressive pterygia demonstrated broadly similar histopathological features, with no significant differences between groups. These findings suggest that clinical classification alone may not reflect underlying tissue changes. Quantitative histomorphometric assessment may improve clinicopathological correlation and disease characterization.