PMC4868928_01
Slit-lamp photograph and mucin mRNA expression on the ocular surface of patient 1. a Slit-lamp photograph of the upper tarsal conjunctiva the right eye showing follicular formation at initial treatment (baseline). b Slit-lamp photograph of the cornea of the right eye showing mild fluorescein staining at initial treatment (baseline). c Photograph of the right eye lid showing swelling and skin erosion at initial treatment (baseline). d Slit-lamp photograph of the cornea of the right eye showing mild fluorescein staining at 3 months after treatment. e Course of MUC5AC mRNA expression on the ocular surface. f Course of MUC16 mRNA expression on the ocular surface. M = Month(s).
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F1
Slit-lamp examination of objective findings of ocular surface showed conjunctival swelling with follicular formation in the upper palpebral conjunctiva (fig. 1a) and SPK with fluorescein staining in the lower mid-peripheral cornea (fig. 1b). Blepharitis with skin erosion caused by pemphigus vulgaris was also observed (fig. 1c), and blinking imperfection might thereby occur. The Schirmer's test value, TBUT, and fluorescein score did not improve after 3 months with combined treatment for dry eye (fig. 1d). However, her subjective symptoms including ocular pain improved dramatically; DEQS score (93.3 to 88.3) and expression levels of ocular surface mucin also improved (shown in fig. 1e, f).
PMC4868928_02
Slit-lamp photographs and mucin mRNA expression on the ocular surface of patient 2. a Slit-lamp photographs of the right eye showing the course of corneal fluorescein staining. b Course of MUC5AC mRNA expression on the ocular surface. c Course of MUC16 mRNA expression on the ocular surface. M = Month(s).
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F2
Slit-lamp examination showed SPK with mucous thread and filamentary keratitis (fig. 2).