Abstract
ABSTRACTLigneous conjunctivitis is a rare form of chronic and recurrent bilateral conjunctivitis, in which thick membranes develop on the tarsal conjunctiva and on other mucosae. We report the case of a 55-year old female patient with bilateral ligneous conjunctivitis who was successfully treated with 50% heterologous serum. There was no recurrence or side effects after one-year follow-up. We suggest the use of 50% heterologous serum should be further studied to better determine its efficacy as a treatment option for ligneous conjunctivitis.
Highlights
❚❚INTRODUCTION Ligneous conjunctivitis is a chronic condition that may be triggered by ocular trauma or surgeries in patients presenting type I plasminogen deficiency.[1,2] The incidence in the general population of type I plasminogen deficiency is 16 cases per 1,000,000 individuals.[1]. The presence of the fibrin-rich pseudomembrane on the tarsal conjunctiva is the typical lesion of ligneous conjunctivitis
Most topical treatments do not produce optimal results for ligneous conjunctivitis: - Hyaluronidase alone (1.5mg/mL) or in combination with alpha-chymotrypsin (0.2mg/mL) can be used for the enzymatic digestion of the mucopolysaccharides that exist on the pseudomembranes.[9,10] - Topical treatment with topical corticosteroids and 2% cyclosporin A may decrease the recurrence of pseudomembranes after surgical excision.[9,10] - Surgical excision of the pseudomembrane can be associated with the administration of topical heparin (1,000 or 5,000 units/mL) and 1% topical prednisolone.[10]. Heparin accelerates the activity of antithrombin III, which inhibits thrombin formation, blocking the conversion of fibrinogen to fibrin
Ligneous conjunctivitis is a chronic condition in patients with type 1 plasminogen deficiency
Summary
Thiago Gonçalves dos Santos Martins, Thomaz Gonçalves dos Santos Martins, Diogo Gonçalves dos Santos Martins, Maria Carolina Francisco Kuba. Ligneous conjunctivitis is a rare form of chronic and recurrent bilateral conjunctivitis, in which thick membranes develop on the tarsal conjunctiva and on other mucosae. We report the case of a 55-year old female patient with bilateral ligneous conjunctivitis who was successfully treated with 50% heterologous serum. The bilateral ocular form is present in 51% of cases, and corneal complications leading to blindness are present in 20 to 30% of patients.[1] Ligneous conjunctivitis treatment is challenging and only partially effective. ❚❚Case report A 55-year-old female patient referred a history of 6-month conjunctivitis not responding to ocular lubricant solutions, 0.3% tobramycin or surgical einstein (São Paulo). The 50% heterologous serum ocular solution was discontinued after one-year use and no ligneous conjunctivitis recurrence was reported
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