Map-dot-fingerprint dystrophy is the abnormal appearance of the basement membrane of the epithelium of the cornea.
Map-dot-fingerprint dystrophy is also called epithelial basement membrane dystrophy.
What Causes Map-Dot-Fingerprint Dystrophy?
Map-Dot-Fingerprint Dystrophy occurs when the epithelium’s basement membrane develops abnormally.
The basement membrane serves as the foundation on which the epithelial cells, which absorb nutrients from tears, anchor and organize themselves.
When the basement membrane develops abnormally, the epithelial cells cannot properly adhere to it.
This, in turn, causes recurrent epithelial erosions, in which the epithelium’s outermost layer rises slightly, exposing a small gap between the outermost layer and the rest of the cornea.
Who Gets Map-Dot-Fingerprint Dystrophy?
Map-dot-fingerprint dystrophy usually affects adults between the ages of 40 and 70. It can also affect children if they inherit it from their parents.
Map-dot-fingerprint dystrophy is usually painless and causes no vision loss, and sometimes clears up without treatment.
Signs and Symptoms
Some patients with Cogan’s dystrophy have no symptoms at all. The symptoms among patients may vary widely in severity and include:
- Light sensitivity
- Fluctuating vision
- Blurred vision
- Irregular astigmatism (uneven corneal surface)
- Mild to extreme irritation and discomfort that is worse in the morning
Detection and Diagnosis
The doctor examines the layers of the cornea with a slit lamp microscope. In some cases, corneal topography may be needed to evaluate and monitor astigmatism resulting from the disease.
Complications of Map-dot-fingerprint Dystrophy
In some cases, epithelial erosion may occur. Epithelial erosion can expose the nerves lining the cornea, causing severe pain. The cornea’s normal curvature may be altered causing astigmatism and nearsightedness
As the cornea is altered, vision may be blurry and accompanied by:
- Moderate to severe pain. The pain will be worse on awakening in the morning.
- Increase sensitivity to light
- Excessive tearing
- A feeling that something is in your eye
Can Map-dot-fingerprint Dystrophy be Treated?
Yes. Treatment may include an eye patch, eye drops, and ointments.
The treatment for Cogan’s is dependent on the severity of the problem. The first step is to lubricate the cornea with artificial tears to keep the surface smooth and comfortable.
Lubricating ointments are recommended at bedtime so the eyes are more comfortable in the morning.
Salt solution drops or ointments such as sodium chloride are often prescribed to reduce swelling and improve vision.
Gas permeable contact lenses are occasionally fitted for patients with irregular astigmatism to create a smooth, even corneal surface and improve vision.
For patients with recurrent corneal erosion, soft, bandage contact lenses may be used to keep the eye comfortable and allow the cornea to heal.
In some cases, laser treatment may beneficial. The surgeon removes the epithelium with an Excimer laser, creating a regular, smooth surface.
The epithelium quickly regenerates, usually within a matter of days, forming a better bond with the underlying cell layer.