PMC3484721_01
Initial slit lamp photograph showing subconjunctival fibrosis, symblepharon, and forniceal foreshortening.
opth-6-1709f1.jpg
PMC3484721_01_opth-6-1709f1.jpg
f1-opth-6-1709
On slit lamp examination the patient had subconjunctival fibrosis, symblepharon, forniceal foreshortening, and trichiasis in both eyes (Figure 1).
Digital photomicrographs of the conjunctival biopsy, showing immunoglobulin G4 deposits in the basement membrane zone.. Notes: Scale bar 5 mum; magnification 200x. Immunofluorescence slides courtesy of Beutner Laboratories, Buffalo, New York.
opth-6-1709f2.jpg
PMC3484721_01_opth-6-1709f2.jpg
f2-opth-6-1709
G4 deposits in the basement membrane zone of the junctional area (Figure 2), consistent with OCP. Given the findings of subconjunctival fibrosis and symblepharon formation in both eyes, the patient was diagnosed with bilateral stage III pemphigoid.
Slit lamp photograph taken 9 months after initiation of phlebotomy treatments, showing significantly reduced inflammation.
opth-6-1709f3.jpg
PMC3484721_01_opth-6-1709f3.jpg
f3-opth-6-1709
Since initiation of the phlebotomy treatments, the patient's conjunctival inflammation and subconjunctival fibrosis has remained quiescent for 4 months without requiring MMF (Figure 3).