Map-dot-fingerprint Dystrophy Clinical Presentation

Updated: Feb 14, 2019
  • Author: David D Verdier, MD; Chief Editor: Hampton Roy, Sr, MD  more...
  • Print
Presentation

History

Most patients with map-dot-fingerprint dystrophy are asymptomatic.

The past eye history may be positive for recurrent corneal erosions.

Visual symptoms are usually mild and occasionally debilitating. Vision is variable and fluctuating due to migratory and intermittent corneal involvement. Refractions often are unstable and are not the fault of the doctor or the patient. Visual complaints include the following:

  • Blurred vision

  • Ghosting or monocular diplopia

  • Glare

  • Distortion

Pain symptoms include the following:

  • Foreign body sensation

  • Photophobia

Next:

Physical

Visual acuity among patients with map-dot-fingerprint dystrophy ranges from 20/15 to 20/200.

Refraction may have an uncertain endpoint due to irregular astigmatism.

On slit lamp examination, pathology is at the epithelial and basement membrane levels. Areas of pathology often are identified best by broad-beam illumination, fluorescein with cobalt blue light (to identify areas of negative staining), or retroillumination following dilation. Slit lamp findings include the following:

  • The corneal maps in map-dot-fingerprint dystrophy are irregular geographic shaped, faint gray-white patches that may contain clear oval areas. They vary greatly in size (usually 1 mm to several mm) and are seen best with broad oblique illumination.

  • The corneal dots in map-dot-fingerprint dystrophy are gray-white, puttylike opacities, which can be round, comma-shaped, or irregular. They are usually 0.05-1 mm in size.

  • The corneal fingerprints in map-dot-fingerprint dystrophy are clusters of contoured concentric lines, 0.25-4 mm in length. They are seen best with retroillumination.

  • Corneal blebs are clear, round, bubblelike defects, 0.05-0.2 mm in diameter. They are seen best with retroillumination. See the images below.

    Corneal maps. Best seen with broad illumination be Corneal maps. Best seen with broad illumination beam.
    Corneal dots. Cluster of corneal dots. Corneal dots. Cluster of corneal dots.
    Corneal fingerprints. Best seen in retroilluminati Corneal fingerprints. Best seen in retroillumination.

Keratometry or computerized topography can be used to check for irregular astigmatism. A Placido disk or keratometer often demonstrates irregularity better than computerized topography.

Previous