The progression and therapeutic outcome of ocular mucous membrane pemphigoid in a Mexican-mestizo population

Abstract

Purpose: To analyze the progression stage and therapeutic outcome of ocular mucous membrane pemphigoid (OMMP) in Mexican-mestizo patients. Methods: This is a single-center, retrospective study of OMMP patients. Ocular and extraocular manifestations, treatment, and visual acuity were recorded from all patients. Outcome measures, including inflammatory control at three months and disease progression, and recurrence were analyzed in patients who completed at least 6 months of follow-up time.Results: Forty-nine eyes from 25 patients (72% women) aged 67.2+11.1 years were initially included. At baseline, 2 (4.1%) eyes were classified as stage-I OMMP, whereas 11 (22.4), 34 (69.4%), and 2 (4.1%) eyes were classified as stages II, III, and IV, respectively. Twenty-seven eyes (14 patients) completed a follow-up time >6 months. Of those, 16 (59%) eyes achieved a complete response at three months under immunosuppressive therapy (IMT), 7 (26%) experienced stage progression, and 17 (63%) had at least one relapse. Mild disease activity (<2+ conjunctival inflammation) at baseline was significantly associated with achieving a complete response after 3 months of IMT (OR 18.0, 1.72–188.08). Systemic steroids were protective against disease relapse (OR 0.06, 0.01–0.60), whereas extraocular manifestations were identified as a risk factor for relapse (OR 10.13, 1.04–98.49). No associated factors with stage progression were found.Conclusions: We found that OMMP patients with extraocular manifestations had an increased risk of recurrent episodes of inflammation. Early and aggressive combined immunosuppression and a closer follow-up are necessary for these patients.