Ocular mucous membrane pemphigoid

Mucous membrane pemphigoid (MMP) is a systemic disease affecting the mucosal surfaces of the eyes, nose, mouth, upper respiratory, and gastrointestinal tracts. Ocular MMP causes inflammation and scarring of the conjunctival surface of the eye that can lead to blindness if not properly treated. Oral corticosteroids, dapsone, and immunosuppressive agents are used to treat ocular MMP with variable success. The most potent and successful treatment for ocular MMP has been daily oral cyclophosphamide, typically in combination with a limited course of oral prednisone. This regimen has been shown to be effective in controlling the ocular inflammation associated with the disease and halting the progression of scarring of the conjunctiva, the major source of ocular morbidity in this disease. Long-term, drug-free remissions have been reported after 12-24 months of this therapy. This article describes treatment modalities for ocular MMP, efficacies, and drug-related side effects associated with treatment, and provides recommendations for follow-up and monitoring of patients with ocular disease.