Ocular involvement in autoimmune bullous diseases

Area of Science:

• Ophthalmology
• Dermatology
• Immunology

Background:

• Autoimmune bullous diseases (AIBDs) are a diverse group of disorders characterized by autoantibodies targeting adhesion molecules.
• Ocular manifestations in AIBDs range from mild irritation to severe vision impairment and blindness.
• Specific AIBDs like pemphigus vulgaris, paraneoplastic pemphigus, and mucous membrane pemphigoid have distinct ocular involvement patterns and prevalence rates.

Purpose of the Study:

• To highlight the spectrum and significance of ocular lesions in autoimmune bullous diseases.
• To emphasize the importance of ophthalmological evaluation for patients with AIBDs.
• To advocate for a multidisciplinary approach in managing ocular complications of AIBDs.

Main Methods:

• Review of literature on ocular manifestations in pemphigus vulgaris, paraneoplastic pemphigus, and mucous membrane pemphigoid.
• Analysis of reported prevalence and clinical signs of ocular involvement in these conditions.
• Emphasis on diagnostic procedures and treatment strategies requiring collaboration.

Main Results:

• Ocular involvement is common in AIBDs, affecting a significant percentage of patients.
• Common signs include conjunctivitis, hyperemia, cicatricial changes, symblepharon, and fornix shortening.
• Pemphigus vulgaris: 7-26% ocular involvement; Paraneoplastic pemphigus: 41-70% ocular involvement; Mucous membrane pemphigoid: 61-70% ocular involvement.

Conclusions:

• Ocular complications in autoimmune bullous diseases can be severe and lead to vision loss.
• Prompt assessment by an ophthalmologist is essential for patients with AIBDs.
• Effective management necessitates close collaboration between dermatologists and ophthalmologists.