University of Texas Southwestern Medical School, University of Texas Southwestern Medical Center, Dallas, Texas.
Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas.
Ophthalmology. 2022 Oct;129(10):1171-1176. doi: 10.1016/j.ophtha.2022.06.001. Epub 2022 Jun 7.
To determine the rate of positivity of immunofluorescence studies in buccal biopsies in patients with cicatrizing conjunctivitis undergoing workup for ocular mucous membrane pemphigoid (MMP)/ocular cicatricial pemphigoid (OCP).
Retrospective cohort review.
Forty-one patients with cicatrizing conjunctivitis undergoing workup for OCP.
A retrospective chart review of direct immunofluorescence (DIF) studies in buccal mucosal biopsies was performed.
The primary outcome measure was the rate of positivity of direct and indirect immunofluorescence studies on buccal mucosal biopsies.
Twenty-two patients (54%) had a positive buccal mucosal biopsy; 64% of patients (14/22) demonstrated +DIF on initial biopsy and an additional 36% of patients (8/22) on the second biopsy. Eighteen patients underwent conjunctival biopsy. In the 6 patients with a negative conjunctival biopsy, 4 (67%) had a positive buccal biopsy.
Buccal mucosal immunofluorescence studies may be positive in patients with OCP even in the absence of extraocular disease. Buccal mucosal biopsy may be considered as an alternative to or attempted before conjunctival biopsy for the diagnosis of OCP, particularly in patients in whom conjunctival biopsy may be difficult or imminently visually threatening.
确定接受眼黏膜类天疱疮（MMP）/眼瘢痕性类天疱疮（OCP）检查的瘢痕性结膜炎患者行口腔黏膜活检免疫荧光检查的阳性率。
回顾性队列研究。
41 例接受 OCP 检查的瘢痕性结膜炎患者。
对口腔黏膜活检的直接免疫荧光（DIF）研究进行回顾性图表审查。
主要观察指标是口腔黏膜活检直接和间接免疫荧光研究的阳性率。
22 例（54%）患者口腔黏膜活检阳性；64%（14/22）的患者初次活检 DIF 阳性，另有 36%（8/22）的患者在第二次活检时 DIF 阳性。18 例患者行结膜活检。在 6 例结膜活检阴性的患者中，有 4 例（67%）口腔活检阳性。
即使没有眼外疾病，OCP 患者的口腔黏膜免疫荧光检查也可能为阳性。口腔黏膜活检可作为 OCP 诊断的替代方法或在结膜活检之前尝试，尤其是在结膜活检可能困难或对视力有潜在威胁的患者中。
