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Dots or microcysts and comma-shaped opacities.
Anterior Basement Membrane Dystrophy

  • Dominantly inherited, also called Map-Dot-Fingerprint Dystrophy or Cogan's microcystic epithelial dystrophy.
  • The most common anterior dystrophy incidentally seen in the ophthalmology practice during routine examination.
  • Clinical features:
    • Symptoms: more commonly asymptomatic.
    • Signs:
      • Bilateral, map-like patterns, fingerprint lines, fine dots (microcysts) or comma-shaped opacities
      • After the third decade of life, about 10% of patients present with recurrent corneal erosions
      • A mild decrease in visual acuity
  • Management:
    • Symptomatic relief by instillation of hypertonic NaCl ointment at bedtime.
    • Mechanical debridement of the involved corneal epithelium and basement membrane.
    • Anterior stromal micropuncture.
    • Phototherapeutic keratectomy may be done in severe case, so that more normally adherent epithelium may replace the dystrophic epithelial-basement membrane.

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