What is Map Dot Fingerprint Dystrophy?
Map Dot Fingerprint corneal dystrophy is a condition that affects the surface of the eye. It goes by many different names, including Anterior Basement Membrane Dystrophy (ABMD), Epithelial Basement Membrane Dystrophy (EBMD), and Cogans Microcystic Dystrophy to name a few. The condition gets its name because the changes in the eye look like someone placed a fingerprint on the surface of the cornea.
In Map Dot Fingerprint, the surface of the cornea becomes irregular over time. This happens because the surface of the cornea forms duplicated and scrolled basement membranes. The epithelial (skin) cells that cover the cornea sit on that basement membrane (Bowman’s Membrane) and any abnormalities to it cause a lumpy, irregular surface of the eye. These changes scatter light and cause blurry vision, especially when they are in the center of the cornea. Some people also end up with scarring of the cornea, though it is unclear the reason why scarring forms.
The basement membrane is the anchor on which the epithelium (skin) rests. In Map Dot Fingerprint dystrophy there are duplicated and rolled basement membranes that cause the surface skin cells to anchor poorly or be weaker than normal ones. This is why 15% of people with this condition have chronic recurrent corneal erosions or abrasions. These erosions can be quite painful and often happen first thing in the morning shortly after waking. Aggressive eye lubrication and salt ointment can help reduce the frequency of these erosions.
It is currently believed that most people with map dot fingerprint do not have an inherited form of the condition, however, there is a group of people with autosomal dominant TGFBI mutations on chromosome 5. That means a small number of map dot fingerprint patients will have the condition run in their family.
The surface changes in map dot fingerprint can cause irregular astigmatism and scarring. Irregular astigmatism and scarring cannot be corrected with glasses. Glasses can only correct regular astigmatism. If you are having trouble seeing in your glasses, you may need a visit with a cornea specialist to determine if you could benefit from an office procedure called a superficial keratectomy with an amniotic membrane graft. A superficial keratectomy involves polishing off the abnormal skin cells. The cornea is then covered with a powerful layer of amniotic membrane to promote healthy skin healing back over the cornea with stronger attachments to the basement membrane and a smooth corneal surface.
Eye pain upon waking in patients with map dot fingerprint dystrophy is caused by recurrent corneal erosions. In patients with map dot fingerprint, the attachments that anchor the cornea skin (epithelium) are weak and can tear easily. At night, it is common for the eye to dry slightly and those surface skin cells may stick to the eyelid more than to the surface of the eye. If that happens, then when you first open your eyelids in the morning you can tear the weak skin attachments causing a corneal abrasion. There are several good treatment options for recurrent corneal erosion syndrome. Consult with a cornea specialist to see which option may be best for you.
There are many treatment options for Map Dot Fingerprint depending on the particular symptom you are experiencing. If you are not suffering from blurry vision, recurrent erosions, or corneal scarring then observation may be appropriate. If you are having recurrent erosions, then using a salt ointment at night such as Muro 128 If Map Dot Fingerprint is causing blurry vision or recurrent erosions, then a polish procedure (called a superficial keratectomy) coupled with either a laser or healing amniotic membrane may be able to improve the vision and reduce or prevent the erosions. If scarring is present, then a similar polish and laser procedure or a specialty contact lens may be able to improve the vision. If you have map dot fingerprint dystrophy, consult with a cornea specialist for an evaluation and to discuss your options.