ABOUT MAP DOT FINGERPRINT DYSTROPHY

Map Dot Fingerprint Corneal Dystrophy or Epithelial Basement Membrane Dystrophy (EBMD) is a condition where the basement membrane under the corneal epithelium does not function properly. As a result epithelial cells cannot properly adhere to it. In most cases, Map Dot Fingerprint dystrophy is sporadic. However, it is most often described as a hereditary dystrophy, more rarely autosomal dominant. The goal of management for EBMD is to improve vision and to reduce the rate of recurrence of corneal erosions.

Ophthalmology Emergency Department, Châteaudun Hospital, France

We report the case of a 50 years old male patient presented in our Emergency Department after a week of sensitivity to light, poor vision, awakening pain in the morning immediately upon opening the eyes, and foreign body sensation in his left eye. He reported the same clinical disorder in his right eye weeks ago spontaneously resolved.

No history of eye surgery or trauma. Visual acuity with correction at distance was 10/10 on the right and 9/10 on the left eye. The intraocular pressure was 11 mmHg on the right and 12 mmHg on the left eye, Pachymetry was 535 µm OD and 543 µm OS. Slit lamp microscopy was unremarkable on the right. However, the biomicroscopy of the left eye revealed : white and quiet Conjunctiva and sclera, epithelial erosions, and fingerprint lines, with no sign of anterior chamber inflammation. Dilated fundus exam was  Normal in both eyes. Treatment options including medical therapy and surgical intervention were discussed with the patient. Initialy, treatment was essentially based on the control of pain and epithelial erosion by using lubricating eye drops combined with nighttime lubricating ointments and patching.  First check didn’t show much improvement.  Therefore, the attempt with scleral lens provide immediate relief and improvement of symptoms. 

 

Epithelial Basement Membrane Dystrophy is a condition that attains in a specific way the epithelium, causing characteristic slit lamp findings which may result in recurrent corneal erosions and decreased vision which varies according to the severity of the corneal damage. The prognosis is very variable. The Dystrophy tends to progress with age although many patients can experience an increase and decrease of symptoms throughout their lives or even an improvement over time.