Abstract
Purpose :
Examine strategies for confirming diagnosis of ocular mucous membrane pemphigoid
(OMMP).
Methods :
IRB approved retrospective chart review was performed on 70 patients identified by EPIC SlicerDicer at Mayo Clinic in Arizona using the ICD-10 code L12.1 mucous membrane pemphigoid on 8/30/2023. Patients were excluded if they had no ocular involvement. These patients were seen by a single cornea specialist in a referral practice and treated in collaboration with the dermatology department. Systemic manifestations of disease and diagnosis methods were extracted.
Results :
39 patients met inclusion criteria. 48.7% of patients experienced various extraocular symptoms which included mucous membrane pemphigoid with oral and esophageal involvement. Diagnosis was confirmed by direct immunofluorescence performed on conjunctival biopsies in 56.4% of patients (22/39). Of the remaining 17 patients, 7 were diagnosed through direct immunofluorescence on mucosal biopsy. Of the then remaining 10 patients, 2 were diagnosed by serology tests including BP 180, BP 230, and DSG3. Diagnosis was made clinically in the remaining 8 patients.
Conclusions :
Patients presenting with conjunctival scarring and trichiasis need to be evaluated for OMMP. Performing conjunctival biopsy with DIF is the gold standard for diagnosis; however, biopsy of already painful and scarred eyes is not easily accepted by patients or ophthalmologists. Collaboration with dermatologists can offer a stepwise approach with serology and mucosal biopsy prior to offering conjunctival biopsy in hopes of getting a diagnosis. In this retrospective study we see that diagnosis was successfully made using either serology or mucosal biopsy in 9 of the 39 patients. These 9 patients benefited by being spared the painful conjunctival biopsy procedure in diagnosis.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.