Autoimmune bullous diseases: ocular manifestations and management.
The ocular manifestations of autoimmune bullous diseases are common and potentially sight-threatening. Major ophthalmic involvement is most commonly seen in mucous membrane pemphigoid (cicatricial pemphigoid), epidermolysis bullosa acquisita, linear IgA bullous disease, pemphigus vulgaris and paraneoplastic pemphigus. The main pathological process is related to autoimmune-induced conjunctival inflammation with consequent lid and corneal pathology, which may eventually result in permanent visual loss. Ocular involvement can be asymptomatic. Early detection is aided by careful attention to symptoms and signs of early ophthalmic disease. Ocular disease can be difficult to treat and management usually involves systemic therapy with immunomodulators to control inflammation and prevent progression to irreversible blindness, as well as surgical intervention in advanced disease. Recent advances in treatment, including methotrexate, mycophenolate mofetil, monoclonal antibodies and topical tacrolimus therapies, have led to promising results.
Laforest
Caroline
C
Oculoplastic & Orbital Unit, Department of Ophthalmology, Royal Adelaide Hospital, University of Adelaide, Adelaide, South Australia, Australia. raheyes@mail.rah.sa.gov.au
Huilgol
Shyamala C
SC
Casson
Robert
R
Selva
Dinesh
D
Leibovitch
Igal
I
D000287:Administration, Topical; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001327:Autoimmune Diseases / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery; D005128:Eye Diseases / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage / Q000627:therapeutic use*; D017445:Skin Diseases, Vascular / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery
D000893:Anti-Inflammatory Agents; D007155:Immunologic Factors