Shanmugam Srinivasan, Muthupandian Vijayanand
BACKGROUND Vitiligo is an acquired depigmentation disorder most commonly due to autoimmunity against melanocyte specific antigens resulting in destruction of the melanocytes in small or large circumscribed areas of the skin. The prevalence of vitiligo is approximately 0.5% and 5% in the world population. Destruction of the Uveal melanocytes and pigment epithelium occurs in vitiligo patients. The ocular manifestations reported in association with vitiligo are hypopigmented spots on the iris, pigmentation on the anterior chamber, RPE hypopigmentation, uveitis, chorioretinal degeneration, peripapillary atrophy around the optic nerve, pigment clumps, focal hypopigmented spots in retina, choroidal naevi, macular oedema, bilateral exudative retinal detachment, subretinal neovascularisation in peripapillary and extrafoveal region. MATERIALS AND METHODS Our study is a prospective cross-sectional study which constitutes 150 clinically proven cases of various types of vitiligo. Ocular examinations including vision recording, slit-lamp biomicroscopy, gonioscopy, intra ocular pressure by applanation tonometer, ophthalmoscopy, examination of fundus by 90 D lens were carried out. Other investigations like complete haemogram, urine analysis, blood biochemistry were done. Demographic factors like age, sex, positive family history, duration of vitiligo, various sites of hypo pigmentation in the body with respect to prevalence of ocular manifestations were analyzed. RESULTS Our study shows female preponderance with iris hypo pigmentation being the most common ocular manifestation. Vitiligo vulgaris is the most common type of vitiligo in our study. In the eye, primarily there is involvement of layers consisting of melanocytes. Iris hypo pigmentation changes are the most frequently followed by fundus changes. In the fundus, diffuse hypopigmentation, background tessellation and temporal crescent are seen. Anterior segment lesions are more compared to posterior segment lesions. The visual loss due to ocular manifestations was not present in our study. CONCLUSION The anatomical localisations, primarily peri orbital and genital vitiligo are the most alerting features for ocular findings.
