Helicobacter pylori Infection of the Gastric Mucosa and Ocular Adnexa—Lack of Association With Ocular Adnexal Lymphoma

Helicobacter pylori Infection of the Gastric Mucosa and Ocular Adnexa—Lack of Association With Ocular Adnexal Lymphoma:

Purpose: Helicobacter pylori could theoretically induce ocular adnexal lymphoma (OAL) via 2 mechanisms: the first is that of infection within the ocular adnexa and the second is that of infection within the gastric mucosa, leading to the malignant transformation of lymphocytes that migrate to the ocular adnexa, forming a primary “ectopic” cancer. This study investigated if an association exists between gastric H. pylori or ocular adnexal H. pylori and OAL. Methods: Prospective case-control study including cases with OAL and controls with nonlymphomatous pathologies. Gastric H. pylori infection was assessed via serologic antibody testing. Ocular adnexal infection was assessed via polymerase chain reaction testing for H. pylori and Chlamydia psittaci within ocular adnexal samples. Results: Seventy-two patients were enrolled, of whom 18 had lymphoma and 54 nonlymphomatous pathologies. H. pylori antibodies were present in 5 cases (28%) and 18 controls (33%) (95% CI, 0.24%–2.50%, p = 0.78). All ocular adnexal specimens were negative for H. pylori and C. psittaci infection. The only relevant statistically significant difference between cases and controls was a history of gastric ulcer (95% CI, 1.23%–44.80%, p = 0.03). Conclusions: In the study’s population, infection of gastric mucosa with H. pylori does not appear to influence the development of OAL. Also, H. pylori or C. psittaci infection within the ocular adnexa does not appear to influence the development of OAL. In the study’s practice, authors do not recommend antibiotic administration or routine gastroscopy for patients with OAL. The authors do recommend referral of OAL patients with gastric symptoms to a gastroenterologist. Accepted for publication May 5, 2020. Supported by the Fonds de recherche en ophtalmologie de l’Université de Montréal (FROUM). The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The authors have no financial or conflicts of interest to disclose. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (www.op-rs.com). Presented at the 2013 ASOPRS annual Fall Scientific Symposium on November 2013 in New Orleans, LA. Address correspondence and reprint requests to Evan Kalin-Hajdu, M.D., Centre Universitaire d’Ophtalmologie Hôpital Maisonneuve-Rosemont 5415, boul. de l’Assomption Montréal (Québec) H1T 2M4, Canada. E-mail: evan.kalin-hajdu@umontreal.ca © 2020 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.