Impression cytology findings in bullous keratopathy

AimTo evaluate, by impression cytology (IC), the cytological features of the central area of corneal epithelial surface of patients with symptomatic bullous keratopathy (BK).DesignCross-sectional observational case series.MethodsIC of the central cornea was performed in 72 eyes of 72 patients with s...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:British journal of ophthalmology 2010-06, Vol.94 (6), p.773-776
Hauptverfasser: Paris, Fabiana dos Santos, Gonçalves, Eliana Domingues, Barros, Jeison de Nadai, de Queiroz Campos, Mauro Silveira, Sato, Élcio Hideo, Gomes, José Álvaro Pereira
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 776
container_issue 6
container_start_page 773
container_title British journal of ophthalmology
container_volume 94
creator Paris, Fabiana dos Santos
Gonçalves, Eliana Domingues
Barros, Jeison de Nadai
de Queiroz Campos, Mauro Silveira
Sato, Élcio Hideo
Gomes, José Álvaro Pereira
description AimTo evaluate, by impression cytology (IC), the cytological features of the central area of corneal epithelial surface of patients with symptomatic bullous keratopathy (BK).DesignCross-sectional observational case series.MethodsIC of the central cornea was performed in 72 eyes of 72 patients with symptomatic BK between June 2005 and December 2006. Patients were divided into two groups according to the presence (group GC) or not of goblet cells (group NGC). The diagnosis of limbal stem cell deficiency (LSCD) was defined by the presence of one or more intact goblet cells on the corneal surface. Squamous metaplasia was classified according to Murube and Rivas.ResultsEpithelial squamous metaplasia was found in 72 (100%) eyes, along with conjunctival goblet cells in 25 (34.72%) eyes. Squamous metaplasia was grade 1 in group GC and more advanced grades in group NGC. Corneal neovascularisation was present in 62 (82.11%) eyes. Vessel measure was more than 4 mm in 11 eyes (23.4%) in group NGC and 10 eyes (40%) in group GC (p=0.559), and they were mostly subepithelial in 23 eyes (48.9%) in group NGC and 12 (48%) eyes in group GC (p=0.822).ConclusionSquamous metaplasia was the most frequent finding associated with advanced BK. The presence of goblet cells on the surface of corneas with squamous metaplasia grade 1, in a significant number of patients, suggests that limbal stem cell deficiency is a common condition associated with advanced cases of BK.
doi_str_mv 10.1136/bjo.2009.158881
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_733110051</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>733110051</sourcerecordid><originalsourceid>FETCH-LOGICAL-b427t-f3cef27cc88da9866df08d7dca73eadab9444b57ea647220b4a44253ba58eae03</originalsourceid><addsrcrecordid>eNqF0F1rFDEUBuAgit1Wr72TASmCMNt8f1zKUmuhKEqt4E04yWTqbGcmazID3X9vyiwteOPVIZwnh5cXoTcErwlh8sxt45pibNZEaK3JM7QiXOqaYmWeoxXGWNWESHKEjnPelieVRL1ER8QYKTQxK8Quh10KOXdxrPx-in283VdtNzbdeJurbqzc3PdxztVdSDDFHUy_96_Qixb6HF4f5gn68en8evO5vvp6cbn5eFU7TtVUt8yHlirvtW7AaCmbFutGNR4UC9CAM5xzJ1QAyRWl2HHgnArmQOgAAbMT9H65u0vxzxzyZIcu-9D3MIYSySrGCMFYkCLf_SO3cU5jCWeJUtpwLIQp6mxRPsWcU2jtLnUDpL0l2D7UaUud9qFOu9RZfrw93J3dEJonf-ivgNMDgOyhbxOMvsuPjlLNTMHF1Yvr8hTuH_eQ7qxUTAn75WZj9a_vP7G4vrHfiv-weDds_5vyL-jjmXY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1778940559</pqid></control><display><type>article</type><title>Impression cytology findings in bullous keratopathy</title><source>Open Access: PubMed Central</source><source>MEDLINE</source><source>BMJ Journals - NESLi2</source><creator>Paris, Fabiana dos Santos ; Gonçalves, Eliana Domingues ; Barros, Jeison de Nadai ; de Queiroz Campos, Mauro Silveira ; Sato, Élcio Hideo ; Gomes, José Álvaro Pereira</creator><creatorcontrib>Paris, Fabiana dos Santos ; Gonçalves, Eliana Domingues ; Barros, Jeison de Nadai ; de Queiroz Campos, Mauro Silveira ; Sato, Élcio Hideo ; Gomes, José Álvaro Pereira</creatorcontrib><description>AimTo evaluate, by impression cytology (IC), the cytological features of the central area of corneal epithelial surface of patients with symptomatic bullous keratopathy (BK).DesignCross-sectional observational case series.MethodsIC of the central cornea was performed in 72 eyes of 72 patients with symptomatic BK between June 2005 and December 2006. Patients were divided into two groups according to the presence (group GC) or not of goblet cells (group NGC). The diagnosis of limbal stem cell deficiency (LSCD) was defined by the presence of one or more intact goblet cells on the corneal surface. Squamous metaplasia was classified according to Murube and Rivas.ResultsEpithelial squamous metaplasia was found in 72 (100%) eyes, along with conjunctival goblet cells in 25 (34.72%) eyes. Squamous metaplasia was grade 1 in group GC and more advanced grades in group NGC. Corneal neovascularisation was present in 62 (82.11%) eyes. Vessel measure was more than 4 mm in 11 eyes (23.4%) in group NGC and 10 eyes (40%) in group GC (p=0.559), and they were mostly subepithelial in 23 eyes (48.9%) in group NGC and 12 (48%) eyes in group GC (p=0.822).ConclusionSquamous metaplasia was the most frequent finding associated with advanced BK. The presence of goblet cells on the surface of corneas with squamous metaplasia grade 1, in a significant number of patients, suggests that limbal stem cell deficiency is a common condition associated with advanced cases of BK.</description><identifier>ISSN: 0007-1161</identifier><identifier>EISSN: 1468-2079</identifier><identifier>DOI: 10.1136/bjo.2009.158881</identifier><identifier>PMID: 19965819</identifier><identifier>CODEN: BJOPAL</identifier><language>eng</language><publisher>BMA House, Tavistock Square, London, WC1H 9JR: BMJ Publishing Group Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; bullous keratopathy ; Cellular biology ; Classification ; Contact lenses ; Cornea ; Corneal Diseases - pathology ; Corneal Neovascularization - pathology ; Cross-Sectional Studies ; Cytodiagnosis - methods ; Cytoplasm ; Diagnostic Techniques, Ophthalmological ; Diseases of cornea, anterior segment and sclera ; Endothelium ; Epithelium, Corneal - pathology ; Female ; goblet cell ; Goblet Cells - pathology ; Humans ; Impression cytology ; Limbus Corneae - pathology ; Male ; Medical sciences ; Metaplasia - pathology ; Middle Aged ; Miscellaneous ; Mucous membrane ; neovascularisation ; Ophthalmology ; Pain ; Patients ; squamous metaplasia ; Statistical analysis ; Stem cells ; Stem Cells - pathology ; Young Adult</subject><ispartof>British journal of ophthalmology, 2010-06, Vol.94 (6), p.773-776</ispartof><rights>2010, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright: 2010 (c) 2010, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b427t-f3cef27cc88da9866df08d7dca73eadab9444b57ea647220b4a44253ba58eae03</citedby><cites>FETCH-LOGICAL-b427t-f3cef27cc88da9866df08d7dca73eadab9444b57ea647220b4a44253ba58eae03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://bjo.bmj.com/content/94/6/773.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://bjo.bmj.com/content/94/6/773.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,780,784,3196,23571,27924,27925,77472,77503</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=22839199$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19965819$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Paris, Fabiana dos Santos</creatorcontrib><creatorcontrib>Gonçalves, Eliana Domingues</creatorcontrib><creatorcontrib>Barros, Jeison de Nadai</creatorcontrib><creatorcontrib>de Queiroz Campos, Mauro Silveira</creatorcontrib><creatorcontrib>Sato, Élcio Hideo</creatorcontrib><creatorcontrib>Gomes, José Álvaro Pereira</creatorcontrib><title>Impression cytology findings in bullous keratopathy</title><title>British journal of ophthalmology</title><addtitle>Br J Ophthalmol</addtitle><description>AimTo evaluate, by impression cytology (IC), the cytological features of the central area of corneal epithelial surface of patients with symptomatic bullous keratopathy (BK).DesignCross-sectional observational case series.MethodsIC of the central cornea was performed in 72 eyes of 72 patients with symptomatic BK between June 2005 and December 2006. Patients were divided into two groups according to the presence (group GC) or not of goblet cells (group NGC). The diagnosis of limbal stem cell deficiency (LSCD) was defined by the presence of one or more intact goblet cells on the corneal surface. Squamous metaplasia was classified according to Murube and Rivas.ResultsEpithelial squamous metaplasia was found in 72 (100%) eyes, along with conjunctival goblet cells in 25 (34.72%) eyes. Squamous metaplasia was grade 1 in group GC and more advanced grades in group NGC. Corneal neovascularisation was present in 62 (82.11%) eyes. Vessel measure was more than 4 mm in 11 eyes (23.4%) in group NGC and 10 eyes (40%) in group GC (p=0.559), and they were mostly subepithelial in 23 eyes (48.9%) in group NGC and 12 (48%) eyes in group GC (p=0.822).ConclusionSquamous metaplasia was the most frequent finding associated with advanced BK. The presence of goblet cells on the surface of corneas with squamous metaplasia grade 1, in a significant number of patients, suggests that limbal stem cell deficiency is a common condition associated with advanced cases of BK.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>bullous keratopathy</subject><subject>Cellular biology</subject><subject>Classification</subject><subject>Contact lenses</subject><subject>Cornea</subject><subject>Corneal Diseases - pathology</subject><subject>Corneal Neovascularization - pathology</subject><subject>Cross-Sectional Studies</subject><subject>Cytodiagnosis - methods</subject><subject>Cytoplasm</subject><subject>Diagnostic Techniques, Ophthalmological</subject><subject>Diseases of cornea, anterior segment and sclera</subject><subject>Endothelium</subject><subject>Epithelium, Corneal - pathology</subject><subject>Female</subject><subject>goblet cell</subject><subject>Goblet Cells - pathology</subject><subject>Humans</subject><subject>Impression cytology</subject><subject>Limbus Corneae - pathology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Metaplasia - pathology</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Mucous membrane</subject><subject>neovascularisation</subject><subject>Ophthalmology</subject><subject>Pain</subject><subject>Patients</subject><subject>squamous metaplasia</subject><subject>Statistical analysis</subject><subject>Stem cells</subject><subject>Stem Cells - pathology</subject><subject>Young Adult</subject><issn>0007-1161</issn><issn>1468-2079</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqF0F1rFDEUBuAgit1Wr72TASmCMNt8f1zKUmuhKEqt4E04yWTqbGcmazID3X9vyiwteOPVIZwnh5cXoTcErwlh8sxt45pibNZEaK3JM7QiXOqaYmWeoxXGWNWESHKEjnPelieVRL1ER8QYKTQxK8Quh10KOXdxrPx-in283VdtNzbdeJurbqzc3PdxztVdSDDFHUy_96_Qixb6HF4f5gn68en8evO5vvp6cbn5eFU7TtVUt8yHlirvtW7AaCmbFutGNR4UC9CAM5xzJ1QAyRWl2HHgnArmQOgAAbMT9H65u0vxzxzyZIcu-9D3MIYSySrGCMFYkCLf_SO3cU5jCWeJUtpwLIQp6mxRPsWcU2jtLnUDpL0l2D7UaUud9qFOu9RZfrw93J3dEJonf-ivgNMDgOyhbxOMvsuPjlLNTMHF1Yvr8hTuH_eQ7qxUTAn75WZj9a_vP7G4vrHfiv-weDds_5vyL-jjmXY</recordid><startdate>20100601</startdate><enddate>20100601</enddate><creator>Paris, Fabiana dos Santos</creator><creator>Gonçalves, Eliana Domingues</creator><creator>Barros, Jeison de Nadai</creator><creator>de Queiroz Campos, Mauro Silveira</creator><creator>Sato, Élcio Hideo</creator><creator>Gomes, José Álvaro Pereira</creator><general>BMJ Publishing Group Ltd</general><general>BMJ Publishing Group</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20100601</creationdate><title>Impression cytology findings in bullous keratopathy</title><author>Paris, Fabiana dos Santos ; Gonçalves, Eliana Domingues ; Barros, Jeison de Nadai ; de Queiroz Campos, Mauro Silveira ; Sato, Élcio Hideo ; Gomes, José Álvaro Pereira</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b427t-f3cef27cc88da9866df08d7dca73eadab9444b57ea647220b4a44253ba58eae03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>bullous keratopathy</topic><topic>Cellular biology</topic><topic>Classification</topic><topic>Contact lenses</topic><topic>Cornea</topic><topic>Corneal Diseases - pathology</topic><topic>Corneal Neovascularization - pathology</topic><topic>Cross-Sectional Studies</topic><topic>Cytodiagnosis - methods</topic><topic>Cytoplasm</topic><topic>Diagnostic Techniques, Ophthalmological</topic><topic>Diseases of cornea, anterior segment and sclera</topic><topic>Endothelium</topic><topic>Epithelium, Corneal - pathology</topic><topic>Female</topic><topic>goblet cell</topic><topic>Goblet Cells - pathology</topic><topic>Humans</topic><topic>Impression cytology</topic><topic>Limbus Corneae - pathology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Metaplasia - pathology</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Mucous membrane</topic><topic>neovascularisation</topic><topic>Ophthalmology</topic><topic>Pain</topic><topic>Patients</topic><topic>squamous metaplasia</topic><topic>Statistical analysis</topic><topic>Stem cells</topic><topic>Stem Cells - pathology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Paris, Fabiana dos Santos</creatorcontrib><creatorcontrib>Gonçalves, Eliana Domingues</creatorcontrib><creatorcontrib>Barros, Jeison de Nadai</creatorcontrib><creatorcontrib>de Queiroz Campos, Mauro Silveira</creatorcontrib><creatorcontrib>Sato, Élcio Hideo</creatorcontrib><creatorcontrib>Gomes, José Álvaro Pereira</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Paris, Fabiana dos Santos</au><au>Gonçalves, Eliana Domingues</au><au>Barros, Jeison de Nadai</au><au>de Queiroz Campos, Mauro Silveira</au><au>Sato, Élcio Hideo</au><au>Gomes, José Álvaro Pereira</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impression cytology findings in bullous keratopathy</atitle><jtitle>British journal of ophthalmology</jtitle><addtitle>Br J Ophthalmol</addtitle><date>2010-06-01</date><risdate>2010</risdate><volume>94</volume><issue>6</issue><spage>773</spage><epage>776</epage><pages>773-776</pages><issn>0007-1161</issn><eissn>1468-2079</eissn><coden>BJOPAL</coden><abstract>AimTo evaluate, by impression cytology (IC), the cytological features of the central area of corneal epithelial surface of patients with symptomatic bullous keratopathy (BK).DesignCross-sectional observational case series.MethodsIC of the central cornea was performed in 72 eyes of 72 patients with symptomatic BK between June 2005 and December 2006. Patients were divided into two groups according to the presence (group GC) or not of goblet cells (group NGC). The diagnosis of limbal stem cell deficiency (LSCD) was defined by the presence of one or more intact goblet cells on the corneal surface. Squamous metaplasia was classified according to Murube and Rivas.ResultsEpithelial squamous metaplasia was found in 72 (100%) eyes, along with conjunctival goblet cells in 25 (34.72%) eyes. Squamous metaplasia was grade 1 in group GC and more advanced grades in group NGC. Corneal neovascularisation was present in 62 (82.11%) eyes. Vessel measure was more than 4 mm in 11 eyes (23.4%) in group NGC and 10 eyes (40%) in group GC (p=0.559), and they were mostly subepithelial in 23 eyes (48.9%) in group NGC and 12 (48%) eyes in group GC (p=0.822).ConclusionSquamous metaplasia was the most frequent finding associated with advanced BK. The presence of goblet cells on the surface of corneas with squamous metaplasia grade 1, in a significant number of patients, suggests that limbal stem cell deficiency is a common condition associated with advanced cases of BK.</abstract><cop>BMA House, Tavistock Square, London, WC1H 9JR</cop><pub>BMJ Publishing Group Ltd</pub><pmid>19965819</pmid><doi>10.1136/bjo.2009.158881</doi><tpages>4</tpages></addata></record>
fulltext fulltext
identifier ISSN: 0007-1161
ispartof British journal of ophthalmology, 2010-06, Vol.94 (6), p.773-776
issn 0007-1161
1468-2079
language eng
recordid cdi_proquest_miscellaneous_733110051
source Open Access: PubMed Central; MEDLINE; BMJ Journals - NESLi2
subjects Adult
Aged
Aged, 80 and over
Biological and medical sciences
bullous keratopathy
Cellular biology
Classification
Contact lenses
Cornea
Corneal Diseases - pathology
Corneal Neovascularization - pathology
Cross-Sectional Studies
Cytodiagnosis - methods
Cytoplasm
Diagnostic Techniques, Ophthalmological
Diseases of cornea, anterior segment and sclera
Endothelium
Epithelium, Corneal - pathology
Female
goblet cell
Goblet Cells - pathology
Humans
Impression cytology
Limbus Corneae - pathology
Male
Medical sciences
Metaplasia - pathology
Middle Aged
Miscellaneous
Mucous membrane
neovascularisation
Ophthalmology
Pain
Patients
squamous metaplasia
Statistical analysis
Stem cells
Stem Cells - pathology
Young Adult
title Impression cytology findings in bullous keratopathy
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-07T20%3A08%3A11IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Impression%20cytology%20findings%20in%20bullous%20keratopathy&rft.jtitle=British%20journal%20of%20ophthalmology&rft.au=Paris,%20Fabiana%20dos%20Santos&rft.date=2010-06-01&rft.volume=94&rft.issue=6&rft.spage=773&rft.epage=776&rft.pages=773-776&rft.issn=0007-1161&rft.eissn=1468-2079&rft.coden=BJOPAL&rft_id=info:doi/10.1136/bjo.2009.158881&rft_dat=%3Cproquest_cross%3E733110051%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1778940559&rft_id=info:pmid/19965819&rfr_iscdi=true