Cornea and External Diseases

Anterior Basement Membrane

Dots or microcysts and comma-shaped opacities.
  • 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.
Fingerprint lines.