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Patricia Chirinos-Saldaña, Isaac Zuñiga-Gonzalez, Julio Hernandez-Camarena, Alejandro Navas, Tito Ramirez-Luquín, Atzin Robles-Contreras, Maria Jimenez-Martinez, Arturo Ramirez-Miranda, Enrique Graue-Hernández; CICATRICIAL CHANGES IN OCULAR PEMPHIGUS. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2053.
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To describe the ophthalmic clinical characteristics in patients with pemphigus at an ophthalmological referral center.
A retrospective chart review of patients with the immunopathological diagnosis of pemphigus examined between January 1, 2000, to April 1, 2010 was performed. Uncorrected distance visual acuity, best corrected distance visual acuity (BCVA), and ocular symptoms as well as ocular surface inflammatory and scarring changes were assessed.
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 1 patient. All eyes showed cicatricial changes in the conjunctiva. Six eyes (36.7%) 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. Mean BCVA logMAR was 1.66 (20/914), range from 0 (20/20) to 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%).
This 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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