| Autor: |
Anesi SD; Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts, USA.; The Ocular Immunology and Uveitis Foundation, Waltham, Massachusetts, USA., Eggenschwiler L; Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts, USA.; The Ocular Immunology and Uveitis Foundation, Waltham, Massachusetts, USA., Ferrara M; Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts, USA.; The Ocular Immunology and Uveitis Foundation, Waltham, Massachusetts, USA.; Department of Neuroscience, Reproductive and Odontostomatological Science, Federico II University, Naples, Italy., Artornsombudh P; Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts, USA.; The Ocular Immunology and Uveitis Foundation, Waltham, Massachusetts, USA., Walsh M; Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts, USA.; The Ocular Immunology and Uveitis Foundation, Waltham, Massachusetts, USA., Foster CS; Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts, USA.; The Ocular Immunology and Uveitis Foundation, Waltham, Massachusetts, USA.; Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA. |
| Abstrakt: |
Purpose : To demonstrate the reliability of conjunctival biopsy analyzed by direct immunofluorescence (DIF) and supplemented with avidin-biotin complex immunoperoxidase (ABC) in diagnosing oMMP, and report therapy response in biopsy-positive patients, particularly when previously biopsy-negative elsewhere. Methods : Retrospective outcomes review of 136 consecutive patients after conjunctival biopsy for suspected oMMP. Results : Among 136 patients, 66% were diagnosed with oMMP by DIF and 13% via supplemental ABC immunoperoxidase. Sensitivity increased from 79.6% with DIF to 95.6% with supplemental ABC. Among 57 biopsy-positive patients, 77% were in remission at 1-year follow-up and 88% after 2 years. Of 34 previous biopsy-negative but now biopsy-positive patients with a 2-year follow-up, 91% achieved remission, including all 16 diagnosed via DIF and ABC. Conclusion : Conjunctival biopsy analyzed by histopathology and DIF supplemented by ABC has high reliability for diagnosing oMMP and is a useful tool to use before starting long-term immunomodulatory therapy in a patient with suspected oMMP. |
