TY - JOUR
T1 - Characterization of Progressive Cicatrizing Conjunctivitis With Negative Immunofluorescence Staining
AU - You, Jae Young
AU - Eberhart, Charles G.
AU - Karakus, Sezen
AU - Akpek, Esen K.
N1 - Funding Information:
Funding/Support: This study received no funding. Financial Disclosures: The authors indicate no financial support or conflicts of interest. All authors attest that they meet the current ICMJE criteria for authorship.
Publisher Copyright:
© 2019
PY - 2020/1
Y1 - 2020/1
N2 - Purpose: To characterize the clinical features of patients with direct immunofluorescence (DIF)-negative mucous membrane pemphigoid (MMP). Design: Retrospective case series. Methods: Thirty-six patients who underwent a conjunctival biopsy for suspected MMP were included. Demographic and clinical information was collected. Main outcome measures included visual acuity, Foster stages, presence of extraocular involvement, history of autoimmune disease, and durations of follow-up. Results: Thirty-two patients had a negative DIF. Of those, 2 had a positive DIF on repeat biopsy. Eleven showed progression of conjunctival scarring during a median follow-up of 42 months (range, 8-100 months) and were diagnosed with biopsy-negative MMP. Another 11 patients with a median follow-up of 54 months (range, 15-138 months) were diagnosed with cicatrizing conjunctivitis of other causes. The median visual acuity of patients with biopsy-negative MMP at presentation was significantly lower compared to patients with cicatrizing conjunctivitis of other causes (20/400 vs 20/40, P =.02). Conjunctival scarring score at presentation in both biopsy-positive and biopsy-negative MMP groups was significantly higher compared to patients with cicatrizing conjunctivitis of other causes (median Foster stage, 3 vs 1, P =.009; and 3 vs 1, P =.01, respectively). Conclusions: Patients with progressive cicatrizing conjunctivitis likely have MMP in the absence of alternate diagnoses. Our findings emphasize that suspicion for MMP must remain high for patients who have Foster stage 3 conjunctival scarring on presentation or worsening of scarring during follow-up, even in the setting of negative DIF.
AB - Purpose: To characterize the clinical features of patients with direct immunofluorescence (DIF)-negative mucous membrane pemphigoid (MMP). Design: Retrospective case series. Methods: Thirty-six patients who underwent a conjunctival biopsy for suspected MMP were included. Demographic and clinical information was collected. Main outcome measures included visual acuity, Foster stages, presence of extraocular involvement, history of autoimmune disease, and durations of follow-up. Results: Thirty-two patients had a negative DIF. Of those, 2 had a positive DIF on repeat biopsy. Eleven showed progression of conjunctival scarring during a median follow-up of 42 months (range, 8-100 months) and were diagnosed with biopsy-negative MMP. Another 11 patients with a median follow-up of 54 months (range, 15-138 months) were diagnosed with cicatrizing conjunctivitis of other causes. The median visual acuity of patients with biopsy-negative MMP at presentation was significantly lower compared to patients with cicatrizing conjunctivitis of other causes (20/400 vs 20/40, P =.02). Conjunctival scarring score at presentation in both biopsy-positive and biopsy-negative MMP groups was significantly higher compared to patients with cicatrizing conjunctivitis of other causes (median Foster stage, 3 vs 1, P =.009; and 3 vs 1, P =.01, respectively). Conclusions: Patients with progressive cicatrizing conjunctivitis likely have MMP in the absence of alternate diagnoses. Our findings emphasize that suspicion for MMP must remain high for patients who have Foster stage 3 conjunctival scarring on presentation or worsening of scarring during follow-up, even in the setting of negative DIF.
UR - http://www.scopus.com/inward/record.url?scp=85075477747&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85075477747&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2019.09.020
DO - 10.1016/j.ajo.2019.09.020
M3 - Article
C2 - 31560878
AN - SCOPUS:85075477747
SN - 0002-9394
VL - 209
SP - 3
EP - 9
JO - American journal of ophthalmology
JF - American journal of ophthalmology
ER -