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.
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Acknowledgements
We would like to thank C Guadalupe Quintero for her assistance with pathologic specimens, and Dr Mark Mannis for his critical review of the paper.
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Chirinos-Saldaña, P., Zuñiga-Gonzalez, I., Hernandez-Camarena, J. et al. Cicatricial changes in ocular pemphigus. Eye 28, 459–465 (2014). https://doi.org/10.1038/eye.2014.3
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DOI: https://doi.org/10.1038/eye.2014.3
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