Demoras en el diagnóstico de penfigoide de la membrana mucosa ocular

Abstract

Objective: To evaluate the time it takes to reach a definitive diagnosis of ocular mucous membrane pemphigoid (OMMP) in a clinical setting of outpatients consulting for dry eye.

Methods: A cross-sectional survey-based study was conducted using self-administered questionnaires to a series of consecutive patients in second-time visits with a diagnosis of PMMO confirmed by conjunctival biopsy. The time elapsed since the onset of symptoms and the number of physicians each patient had seen before reaching the diagnosis were asked. Subsequent clinical examination was performed.

Results: The sample consisted of 90 subjects with a mean age of 60.6 ± 11 years, where females accounted for 84.4%. The subjects reported a delay in diagnosis of about 4.6 ± 3.5 years. In addition, patients reported that they started with symptoms 5.9 ± 3.5 years before diagnosis, consulting an average of 5 different ophthalmologists before definitive diagnosis (average 4.9 ± 2.8 ophthalmologists, range between 1 and 20). The most frequent previous ophthalmologic diagnoses with which they presented to our office were: ocular allergy (96.7%), dry eye (96.7%) and tear duct obstruction (40%). It should be noted that 46.7% reported having had aphthous ulcers in the oral mucosa and 36% presented with skin rosacea as extraocular signs that suggest a diagnosis of PMMO.

Conclusion: There are many years of delay from the onset of symptoms until the definitive diagnosis of PMMO is reached.