Ligneous conjunctivitis

Ligneous conjunctivitis is a rare form of chronic conjunctivitis characterized by recurrent, fibrin-rich pseudomembranous lesions of wood-like consistency that develop mainly on the underside of the eyelid (tarsal conjunctiva).[1] It is generally a systemic disease which may involve the periodontal tissue, the upper and lower respiratory tract, kidneys, middle ear, and female genitalia.[2] It can be sight-threatening,[2] and death can occasionally occur from pulmonary involvement.

It has been speculated that ligneous conjunctivitis may be a manifestation of IgG4-related disease (IgG4-RD) involving the conjunctiva.[3]

Pathogenesis

Histopathological findings from affected humans indicate that wound healing is impaired due to a deficiency in plasmin-mediated extracellular fibrinolysis.[1] Episodes may be triggered by minor trauma, eye surgery, or by systemic events such as infections or antifibrinolytic therapy.[2] Histology shows amorphous subepithelial deposits of eosinophilic material consisting predominantly of fibrin.

Treatment

Ligneous conjunctivitis may be managed by topical treatments of plasminogen,[1] topical and subconjunctival fresh frozen plasma,[1] and fibrinolytic therapy.[4]

References

  1. 1 2 3 4 Schuster, V.; Seregard, S. (2003). "Ligneous conjunctivitis". Survey of ophthalmology. 48 (4): 369–388. doi:10.1016/s0039-6257(03)00056-0. PMID 12850227.
  2. 1 2 3 "Ligneous conjunctivitis". Orphanet. Retrieved July 21, 2012.
  3. ↑ Chiang Wei-Yu; iu Ting-Ting; Huang Wan-Ting; Kuo Ming-Tse (9 September 2016). "Co-existing ligneous conjunctivitis and IgG4-related disease". Indian Journal of Ophthalmology. 64 (7): 532–534. doi:10.4103/0301-4738.190154.
  4. ↑ "Ligneous Conjunctivitis". Ocular Pathology. Retrieved July 21, 2012.
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