From the Guidelines
Epithelial Basement Membrane Dystrophy (EBMD) is a condition that affects the cornea, specifically the epithelial basement membrane, and can be managed with epithelial debridement.
Key Characteristics of EBMD
- EBMD is a condition that can cause lesions anterior to Bowman's layer, leading to symptoms such as corneal edema and opacification 1
- The condition is characterized by a loose and easily removable epithelium, with a multilayered basement membrane that may be present 1
Management of EBMD
- Epithelial debridement is a common treatment for EBMD, which involves the removal of the epithelium until the smooth, shiny Bowman's layer is exposed 1
- Following debridement, a therapeutic bandage contact lens (BCL) and prophylactic topical antibiotics may be applied, along with a short course of topical nonsteroidal anti-inflammatory (NSAID) drops to control discomfort 1
- Excimer phototherapeutic keratectomy (PTK) may also be used to manage EBMD, particularly in cases where there are superficial or anterior stromal opacities 1
From the Research
Definition and Characteristics of Epithelial Basement Membrane Dystrophy (EBMD)
- Epithelial Basement Membrane Dystrophy (EBMD) is a rare entity characterized by recurrent corneal erosions secondary to a disorder in the attachment of the corneal epithelium to the basement membrane 2.
- EBMD is characterized by an abnormal basement membrane protruding toward the epithelium and epithelial microcysts 3.
- The condition encompasses microcystic dystrophy and other conditions affecting the epithelial basement membrane 4.
Clinical Features and Diagnosis
- EBMD can cause painless visual disturbances, and decreased vision is usually associated with pain from corneal epithelial erosion 5.
- The condition can be diagnosed using in vivo confocal microscopy, which provides better resolution and outlines distinctively in vivo microstructural characteristics of EBMD 3.
- Slit lamp examination and retroillumination through a dilated pupil can also be used to demonstrate EBMD 5.
Classification and Treatment
- EBMD is classified as an epithelial and subepithelial dystrophy of the cornea, according to the international classification of corneal dystrophies (IC3D) 6.
- Treatment of EBMD includes alleviating blurred vision, treating recurrent corneal erosion, or both, and may involve mechanical debridement of the loosened epithelium, phototherapeutic keratectomy (PTK), or keratoplasty 4, 6.