P Chirinos-Saldaña1, I Zuñiga-Gonzalez1, J C Hernandez-Camarena1, A Navas1, T Ramirez-Luquin1, A Robles-Contreras2, M C Jimenez-Martinez3, A Ramirez-Miranda1, V M Bautista-de Lucio4, E O Graue-Hernandez1. 1. Cornea and Refractive Surgery Department, Institute of Ophthalmology 'Fundación de Asistencia Privada Conde de Valenciana', Mexico City, Mexico. 2. Immunology Department, Research Unit Institute, Institute of Ophthalmology 'Fundación de Asistencia Privada Conde de Valenciana', Mexico City, Mexico. 3. 1] Immunology Department, Research Unit Institute, Institute of Ophthalmology 'Fundación de Asistencia Privada Conde de Valenciana', Mexico City, Mexico [2] Immunology Lab, Department of Biochemistry, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico. 4. Microbiology and Ocular Proteomics Department, Research Unit, Institute of Ophthalmology 'Fundación de Asistencia Privada Conde de Valenciana', Mexico City, Mexico.
Abstract
PURPOSE: To describe the clinical characteristics of ocular involvement in patients with pemphigus at an ophthalmological referral center. METHODS: A retrospective review was conducted on patients with the immunopathological diagnosis of pemphigus examined between 1 January 2000 and 1 April 2010. Uncorrected distance visual acuity (UDVA), best corrected distance visual acuity (BCVA), ocular symptoms, and ocular surface inflammatory and scarring changes were assessed. RESULTS: A total of 15 patients were identified, with a mean age of 68.27 ± 14.35 years, and 80% (n=12) were female. Extraocular involvement was reported in one patient. All of the eyes showed cicatricial changes in the conjunctiva. In all, 6 eyes (20%) were classified as stage I; 12 eyes (40%) as stage II; 10 eyes (33%) as stage III; and 2 eyes (7%) as stage IV. A statistically significant association was found between BCVA and the severity of ocular involvement. The mean BCVA logMAR was 1.66 (20/914), with a range from logMAR 0 (20/20) to logMAR 4 (NLP). Other ocular diseases were found in 8 (53.3%), systemic diseases in 10 (66.7%), and the use of pemphigus-inducing drugs in 10 patients (66.7%). CONCLUSIONS: The present report represents the largest series of ocular involvement in pemphigus confirmed by immunopathology. The clinical manifestations varied from conjunctival hyperemia to corneal scarring and perforation. There was a strong association between scarring changes and low BCVA. Ocular and systemic diseases as well as the use of pemphigus-inducing drugs may predispose to ocular cicatricial changes observed in this series.
PURPOSE: To describe the clinical characteristics of ocular involvement in patients with pemphigus at an ophthalmological referral center. METHODS: A retrospective review was conducted on patients with the immunopathological diagnosis of pemphigus examined between 1 January 2000 and 1 April 2010. Uncorrected distance visual acuity (UDVA), best corrected distance visual acuity (BCVA), ocular symptoms, and ocular surface inflammatory and scarring changes were assessed. RESULTS: A total of 15 patients were identified, with a mean age of 68.27 ± 14.35 years, and 80% (n=12) were female. Extraocular involvement was reported in one patient. All of the eyes showed cicatricial changes in the conjunctiva. In all, 6 eyes (20%) were classified as stage I; 12 eyes (40%) as stage II; 10 eyes (33%) as stage III; and 2 eyes (7%) as stage IV. A statistically significant association was found between BCVA and the severity of ocular involvement. The mean BCVA logMAR was 1.66 (20/914), with a range from logMAR 0 (20/20) to logMAR 4 (NLP). Other ocular diseases were found in 8 (53.3%), systemic diseases in 10 (66.7%), and the use of pemphigus-inducing drugs in 10 patients (66.7%). CONCLUSIONS: The present report represents the largest series of ocular involvement in pemphigus confirmed by immunopathology. The clinical manifestations varied from conjunctival hyperemia to corneal scarring and perforation. There was a strong association between scarring changes and low BCVA. Ocular and systemic diseases as well as the use of pemphigus-inducing drugs may predispose to ocular cicatricial changes observed in this series.
Authors: Brendon W H Lee; Jeremy C K Tan; Melissa Radjenovic; Minas T Coroneo; Dedee F Murrell Journal: Orphanet J Rare Dis Date: 2018-05-22 Impact factor: 4.123