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Updated: Sep 13, 2026
Technique of Conjunctival Biopsy and Direct Immunofluorescence for Diagnosing Mucous Membrane Pemphigoid
Published on: June 17, 2025
Conjunctival biopsy findings associated with fibrosis and sequelae in ocular Mucous membrane pemphigoid
Ariana Ringer1,2,3, Andrea Smichowski4, Carlos Nuncio Siegrist1
1Clínica y Laboratorio Inmunológico Especializado CM/LABI, Rosario, Santa Fe, Argentina.
Purpose:
Ocular mucous membrane pemphigoid (OcMMP) leads to fibrosis of the conjunctiva with potential sequelae. Our objective was to describe biopsies from patients with OcMMP and identify biopsy characteristics associated with fibrosis and sequelae.
Methods:
Patients with histologically confirmed OcMMP were selected. Fibrosis grades were defined according to Foster's stages. The subjects were divided into two groups: early stages (0 and 1) versus later stages (2, 3, and 4). A Cox multivariate analysis was performed to determine whether immunofluorescence deposits were associated with sequelae.
Results:
Fifty-seven patients were included. The mean age at diagnosis was 62.7 (SD 13.2) years, and 41 (71.9%) were women. The follow-up time was 1.5 years (IQR 0.3-3). Patients with early Foster were 50.9%. The presence of mast cells was associated with early stages, whereas eosinophils were associated with later stages at the time of diagnosis. In the multivariate Cox regression analysis, the presence of IgA deposits was associated with developing sequelae (HR 10.8; IC 95% 1.3-92.9; p 0.03).
Conclusion:
Eosinophils were more frequently observed in patients with advanced Foster stages, and IgA was associated with the sequelae.
