Viral nucleic acid analysis with PCR in lacrimal tissue and nasal swab samples of primary acquired nasolacrimal duct obstruction cases

Yanik, Özge; Hosal, Banu; Tekeli, Alper; Nalci, Hilal

Primary acquired nasolacrimal duct obstruction (PANDO) is the most common cause of epiphora in adults. 1 A variety of anatomical, endocrine, environmental, and socioeconomic risk factors have been suggested in the etiology; however, the precise pathogenesis of PANDO has not yet been elucidated. Previous histopathological studies have revealed chronic inflammation of the nasolacrimal duct and the development of secondary fibrosis on the ground of this inflammation. [2] [3] [4] PANDO has been reported to be able to occur secondary to unrecognized low-grade dacryocystitis. 5 In one experimental model of dacryocystitis, the number of collagen fibers and fibrocytes in the lamina propria had increased 3 months after a Staphylococcus aureus inoculation. 6 Viruses, as superior to bacteria, have capability to extend beyond the epithelium to involve the elastic tissue of the lamina propria, causing inflammation and cicatricial changes in the mucosa. 5 Recently, viral infections have been reported as the possible trigger factors in the pathogenesis of several diseases, such as idiopathic pulmonary fibrosis, dilated cardiomyopathy, and arrhythmogenic right ventricular dysplasia, characterized by inflammation and secondary fibrosis in their histopathological examinations. [7] [8] [9] [10] A similar mechanism may be possible for the pathogenesis of PANDO which has common histopathological characteristics with these diseases.