[Immunology-related chronic progressive cicatricial conjunctival diseases: diagnosis, therapy and prognosis].

Abstract

PURPOSE:

We reviewed the records of patients with chronic cicatricial disease of the conjunctiva for differences in prognosis between clinical and histopathological subgroups of the disease and in therapeutic options.

PATIENTS:

In 30 patients (58 eyes) with an average age of 69 years (52-86) chronic cicatricial disease of the conjunctiva was diagnosed clinically. Only in 22/30 patients conjunctival biopsies could be performed. The correlation of histopathological and immunohistochemical diagnoses with clinical course under systemic immunosuppression was studied.

RESULTS:

15/22 biopsies led to a classification into different subgroups. Under systemic immunosuppression disease ceased to progress for a mean time of 15 months in 13 of 15 patients with positive biopsies and in 9 of 15 without classification. The results after cyclosporine A therapy (4 of 5 patients stabilized after a mean of 27.5 months) and mycophenolate mofetil (8 of 11 patients stabilized at a mean of 7.8 months) were better than those after therapy with dapsone, azathioprine and cyclophosphamide.

CONCLUSIONS:

Histopathological and immunohistochemical examinations led to a classification in two-thirds of the patients with clinical aspects of chronic cicatricial disease of the conjunctiva. There was no correlation between different histopathological subgroups, success of therapy and prognosis of the disease. There is little hope in using new systemic immunosuppression such as cyclosporine A and mycophenolate mofetil.

• Authors: W Marx, T Reinhard, M Megahed, R Sundmacher
• Journal: Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft (Ophthalmologe) Vol. 98 Issue 2 Pg. 185-93 (Feb 2001) ISSN: 0941-293X [Print] Germany
• Vernacular Title: Immunologisch bedingte, chronisch-progressiv vernarbende Bindehauterkrankungen. Diagnose, Therapie und Prognose.
• PMID: 11263046 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Immunoglobulin A
• Immunosuppressive Agents
• Cyclosporine
• Mycophenolic Acid

Topics

• Aged
• Aged, 80 and over
• Chronic Disease
• Conjunctival Diseases (diagnosis, drug therapy, immunology)
• Cyclosporine (therapeutic use)
• Diagnosis, Differential
• Female
• Humans
• Immunoglobulin A (analysis)
• Immunosuppressive Agents (therapeutic use)
• Male
• Middle Aged
• Mycophenolic Acid (analogs & derivatives, therapeutic use)
• Pemphigoid, Bullous (diagnosis, drug therapy, immunology)
• Prognosis