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Als Produkt ist OpenEvidence ein KI‑Co‑Pilot für Ärztinnen, der ihnen hilft, hochriskante Entscheidungen direkt am Ort der Versorgung zu treffen. OpenEvidence ist die am weitesten verbreitete medizinische KI unter verifizierten US‑Ärztinnen. Bis heute haben wir über 100 Millionen KI‑gestützte klinische Konsultationen von US‑ÄrztInnen und anderen Fachkräften an vorderster Front unterstützt.

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Test zu 'Map-Dot-Fingerprint Dystrophy'

PROMPT

Map-Dot-Fingerprint Dystrophy

Map-Dot-Fingerprint Dystrophy is a common, non-inflammatory corneal epithelial disorder, also known as epithelial basement membrane dystrophy (EBMD). It is characterized by abnormal production and deposition of basement membrane material in the corneal epithelium, leading to distinctive patterns visible on slit-lamp examination: "maps" (geographic or patchy areas), "dots" (small, round opacities), and "fingerprints" (whorled or curvilinear lines). [1]

Clinically, patients may be asymptomatic or present with recurrent corneal erosions, fluctuating vision, monocular diplopia, or visual disturbances due to irregular astigmatism. The pathogenesis involves defective adhesion between the corneal epithelium and its basement membrane, predisposing to epithelial breakdown and erosions. [1-2]

Diagnosis is based on clinical examination, with in vivo confocal microscopy able to demonstrate microstructural changes such as highly reflective deposits and abnormal basement membrane patterns. [1] Treatment is indicated for symptomatic cases, particularly those with recurrent erosions or visual impairment. First-line management includes lubricating eye drops and hypertonic saline ointments. For persistent or severe cases, procedures such as epithelial debridement or phototherapeutic keratectomy (PTK) with excimer laser have demonstrated efficacy in improving vision and resolving erosions, with stable long-term outcomes. [2]

Map-Dot-Fingerprint Dystrophy is not associated with systemic disease and typically has a benign course, though recurrent erosions can significantly impact quality of life. [1-2]

1. In Vivo Laser Confocal Microscopy Findings in Patients With Map-Dot-Fingerprint (Epithelial Basement Membrane) Dystrophy.
   Clinical Ophthalmology. 2012. Kobayashi A, Yokogawa H, Sugiyama K.
2. Phototherapeutic Keratectomy for Map-Dot-Fingerprint Corneal Dystrophy.
   Cornea. 1998. Orndahl MJ, Fagerholm PP.

PROMPT

summarize the latest evidence comparing the
long-term outcomes and recurrence rates of
different procedural treatments

The latest evidence indicates that both phototherapeutic keratectomy (PTK) and epithelial debridement (with or without diamond burr polishing) are effective procedural treatments for recurrent erosions in Map-Dot-Fingerprint Dystrophy (epithelial basement membrane dystrophy), but there are important differences in long-term outcomes and recurrence rates.

PTK provides durable symptomatic relief, with long-term follow-up studies showing that the majority of patients remain recurrence-free for several years. Recurrence rates of symptomatic erosions after PTK range from 0% to 23% over 1–5 years, with most recurrences occurring within the first year and often manageable with repeat PTK. Visual acuity typically improves or remains stable, and adverse effects such as haze are generally mild and transient. [1-5] However, recurrence of morphologic dystrophic changes (without symptoms) is common over time, though these are often asymptomatic. [3-4]

Epithelial debridement with diamond burr polishing is a simpler, office-based procedure. Long-term resolution of erosions is achieved in approximately 90–97% of cases, with recurrence rates reported as 11–15% over 1–3 years. Visual outcomes are favorable, and the risk of haze is low and not associated with decreased vision. [6-8] Comparative studies suggest no statistically significant difference in recurrence or haze rates between PTK and diamond burr polishing, but diamond burr polishing may have a trend toward lower recurrence and haze, and is less resource-intensive. [7]

Direct comparisons between PTK and epithelial debridement alone (without diamond burr) suggest higher recurrence with debridement alone, making adjunctive diamond burr polishing preferable. [6-8]

In summary, both PTK and diamond burr polishing after epithelial debridement are effective for long-term control of recurrent erosions in Map-Dot-Fingerprint Dystrophy, with recurrence rates generally below 25% over several years; PTK may offer slightly longer recurrence-free intervals, but diamond burr polishing is less invasive and similarly effective. [2-8] Choice of procedure should be individualized based on patient needs, available resources, and surgeon experience.

1. Phototherapeutic Keratectomy for Map-Dot-Fingerprint Corneal Dystrophy.
   Cornea. 1998. Orndahl MJ, Fagerholm PP.
2. Phototherapeutic Keratectomy for Epithelial Basement Membrane Dystrophy.
   Clinical Ophthalmology. 2016. Lee WS, Lam CK, Manche EE.
3. Clinical Outcome and Recurrence of Epithelial Basement Membrane Dystrophy After Phototherapeutic Keratectomy a Cross-Sectional Study.
   Ophthalmology. 2011. Germundsson J, Fagerholm P, Lagali N.
4. Long-Term Results of Phototherapeutic Keratectomy for Corneal Map-Dot-Fingerprint Dystrophy (Cogan-Guerry).
   Cornea. 2006. Pogorelov P, Langenbucher A, Kruse F, Seitz B.
5. Phototherapeutic Keratectomy for Recurrent Erosion Syndrome in Anterior Basement Membrane Dystrophy.
   Ophthalmology. 1999. Cavanaugh TB, Lind DM, Cutarelli PE, et al.
6. Demographic Patterns and Treatment Outcomes of Patients With Recurrent Corneal Erosions Related to Trauma and Epithelial and Bowman Layer Disorders.
   American Journal of Ophthalmology. 2013. Suri K, Kosker M, Duman F, et al.
7. Phototherapeutic Keratectomy Versus Diamond Burr Polishing of Bowman's Membrane in the Treatment of Recurrent Corneal Erosions Associated With Anterior Basement Membrane Dystrophy.
   Ophthalmology. 2002. Sridhar MS, Rapuano CJ, Cosar CB, Cohen EJ, Laibson PR.
8. Long-Term Outcomes of Epithelial Debridement and Diamond Burr Polishing for Corneal Epithelial Irregularity and Recurrent Corneal Erosion.
   Cornea. 2015. Vo RC, Chen JL, Sanchez PJ, Yu F, Aldave AJ.