Abstract
Purpose :
While much research has been done on systemic immunomodulatory therapy (IMT) for ocular cicatricial pemphigoid (OCP), there is limited data guiding clinicians regarding treatment of the associated ocular surface disease (OSD). Here, we evaluate the use of treatments specifically for OCP-related OSD at our institution.
Methods :
We performed a retrospective analysis of all patients seen between 1/1/2013and 10/31/2023 at the University of Colorado Hospital with a diagnosis of cicatrizing conjunctivitis. Patients with a cicatrizing conjunctivitis secondary to diseases other than OCP were excluded.
Results :
A total of 57 charts were reviewed. 27 patients were excluded. A total of 30 patients were included in our analysis, 13 (43.3%) of whom had biopsy or serum antibody-positive findings for OCP. 19 patients were female (63.3%). The mean age of symptom onset was 62 years, while the mean age of diagnosis was 65. The most common initial symptoms included irritation, dryness, and tearing. 27 patients (90%) were being treated with systemic IMT.
The most common treatments for OSD at the most recent visit included preservative-free artificial tears (87%), autologous serum eye drops (40%), topical corticosteroids (40%), topical immunomodulators (30%), and topical antibiotics (30%). 10% of patients were also being treated with scleral contact lenses. The most common prior treatments included topical corticosteroids (43%), topical antibiotics (43%), topical immunomodulators (33%), bandage contact lenses (23%), autologous serum eye drops (23%), and amniotic membrane transplantation (20%). 10% of patients previously worse scleral contact lenses, but not at the most recent visit.
Conclusions :
OSD is a common co-morbidity in OCP, with substantial variability in severity of patient symptoms and resulting ocular surface damage. In our cohort, almost all patients were being treated with preservative-free artificial tears. The most common prescription treatments were autologous serum eye drops, topical corticosteroids, and topical immunomodulators. The average patient was utilizing 3.33 treatments with 1.7 of those treatments being prescription. On average, patients had tried 3.43 previous treatments with 2.6 of those being prescription.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.