icd-9 code for anterior basement membrane dystrophy

by Nyasia Zboncak 7 min read

59 Anterior Corneal Dystrophies. Epithelial basement membrane dystrophy (EBMD) is a degenerative condition of the anterior layer of the cornea.Aug 6, 2016

Full Answer

What is the ICD 10 code for anterior basement membrane dystrophy?

I'm told Anterior basement membrane dystrophy (ABMD) and MDF are very similar. Answer: The ICD-10-CM for Ophthalmology: The Complete Reference maps 371.52 Map- dot fingerprint corneal dystrophy to H18.59 Other hereditary corneal dystrophies. There is no laterality; only one code.

What is anterior basement membrane corneal dystrophy?

Anterior Basement Membrane Corneal Dystrophy is the official name for Map Dot Fingerprint Corneal Dystrophy. In this condition, the basement membrane under the corneal epithelium does not function properly. The basement membrane functions as a sticky anchor over which the epithelium grows. The basement membrane stabilizes the epithelium.

What is the ICD 10 code for corneal dystrophy?

ICD-10 Diagnosis Code: H18.59–Other hereditary corneal dystrophy. Title Anterior Corneal Dystrophies Category Corneal Opacity And Other Disorders Of Cornea. Description Epithelial basement membrane dystrophy (EBMD) is a degenerative condition of the anterior layer of the cornea.

How is anterior basement membrane dystrophy diagnosed?

Anterior Basement Membrane Dystrophy: An Overview for Patients. Blurred vision associated with ABMD will generally result in an irregular corneal contour that can be diagnosed with the aid of corneal topography, a noninvasive diagnostic test that measures the smoothness and contour of the corneal surface.

What is anterior basement membrane dystrophy?

Anterior Basement Membrane Dystrophy (ABMD) is an inherited disorder of the cornea that may present with a variety of symptoms, including recurrent corneal erosions and/or blurred vision. ABMD is a type of corneal dystrophy that affects the thin outside layer of the cornea.

What causes epithelial basement membrane dystrophy?

Known family history and age are probably the most important risk factors for EBMD. There are no known controllable risk factors. Risk factors for progression or exacerbation of the disease include trauma such as corneal abrasion, LASIK, or other intraocular surgery.

What is corneal dystrophy?

Corneal dystrophies are eye diseases that involve changes in the cornea (the clear front layer of your eye). These diseases usually run in families. Most corneal dystrophies are progressive — they get worse over time. Some cause vision loss or pain, but some have no symptoms.

What is map dot corneal dystrophy?

What is Map Dot Fingerprint Dystrophy? Map Dot Fingerprint Dystrophy (MDF) is a hereditary disease of the “epithelium” or anterior “skin” cells of the cornea. Multiple names are used to describe this condition such as epithelial basement membrane dystrophy, Cogan's microcystic dystrophy, or anterior membrane dystrophy.

Is epithelial basement membrane dystrophy rare?

Epithelial basement membrane dystrophy is a common form of corneal dystrophy and is also known as map-dot-fingerprint dystrophy and Cogan microcystic dystrophy. This extremely rare form of corneal dystrophy affects the epithelial layer of the cornea.

How do you treat epithelial basement membrane dystrophy?

You can do a simple epithelial debridement, where you just scrape off all of the loose epithelium. This usually works well. Sometimes, a microscopic irregular basement membrane is left underneath the epithelium, and if you want to remove that, you can use a diamond burr polisher.

What is the most common corneal dystrophy?

The most common is Fuchs' corneal dystrophy, which usually starts when you're in your 40s or 50s. It may take several more years, even decades before you notice vision problems. With Fuchs', the cells that pump excess moisture out of your cornea to keep it clear start to die.

What is the difference between dystrophy and degeneration?

Degenerations are usually unilateral, asymmetric and often peripheral. Changes caused by inflammation, maturity or systemic disease result in deposition, thinning or vascularization of the corneal tissue. Dystrophies are rare conditions and may not present in a primary setting.

What does endothelial corneal dystrophy mean?

Fuchs endothelial corneal dystrophy (FECD) is characterized by progressive loss of corneal endothelial cells, thickening of Descement's membrane and deposition of extracellular matrix in the form of guttae. When the number of endothelial cells becomes critically low, the cornea swells and causes loss of vision.

Does map dystrophy cause blindness?

This condition is common, treatable, and rarely leads to significant vision loss.

How common is map dot dystrophy?

Frequency. Estimates of the prevalence of map-dot-fingerprint dystrophy range from 2-43% of the general population. Of patients with map-dot-fingerprint dystrophy, 10-33% have recurrent corneal erosions. As many as 50% of patients with recurrent corneal erosions have map-dot-fingerprint dystrophy.

What is the cause of corneal dystrophy?

The autosomal recessive form of congenital hereditary endothelial corneal dystrophy is due to mutations in the SLC4A11 gene on chromosome 20(20p13). The gene for autosomal dominant congenital hereditary endothelial corneal dystrophy has not been identified, but it is located on the short arm of chromosome 20 (20p11.

What causes Abmd?

What causes ABMD? ABMD occurs when the epithelium does not develop properly. It may have trouble sticking to the tough inner layer of the cornea called the stroma. A person with ABMD may easily develop a scratch or erosion on the cornea, even from very minor trauma like rubbing or opening the eyes.

Is EBMD serious?

Most people with EBMD do not have symptoms and may not be aware they have EBMD. Those who do have symptoms may have mild to severe blurry vision and pain, sensitivity to light, excessive tearing, and a feeling that something is in the eye.

Is there a cure for corneal dystrophy?

Corneal dystrophy is an inherited condition, which means prevention is a mystery. The good news is that this condition is treatable.

Does laser surgery cause epithelial dystrophy?

Epithelial ingrowth is a common postoperative complication of epithelial sloughing. Epithelial ingrowth is reported in a 46% to 71% of the eyes that experienced epithelial sloughing during LASIK.

What is the name of the condition where the basement membrane is not functioning properly?

Anterior Basement Membrane Corneal Dystrophy is the official name for Map Dot Fingerprint Corneal Dystrophy. In this condition, the basement membrane under the corneal epithelium does not function properly. The basement membrane functions as a sticky anchor over which the epithelium grows. The basement membrane stabilizes the epithelium. There are generally two conditions which cause basement membrane dysfunction – one inherited, and one acquired by a deep corneal abrasion (scratch) which damages the basement membrane. This condition is common, treatable, and rarely leads to significant vision loss.

What is the function of the basement membrane?

The basement membrane stabilizes the epithelium. There are generally two conditions which cause basement membrane dysfunction – one inherited, and one acquired by a deep corneal abrasion (scratch) which damages the basement membrane. This condition is common, treatable, and rarely leads to significant vision loss.

What are the symptoms of ABMD?

Most patients who have ABMD don’t have any symptoms. However, when the basement membrane doesn’t stabilize the epithelium properly, two sets of symptoms may occur.

What is the abnormal basement membrane?

The abnormal basement membrane migrates into the corneal epithelium and produces focal areas of elevation . The elevated edges of the lesions have a scalloped shape and can produce tear film abnormalities that are visible with fluorescein and a cobalt blue light.

What is the anterior layer of the cornea?

The anterior layer of the cornea is composed of the corneal epithelium and its underlying basement membrane. The basal cells of the corneal epithelium produce and adhere to the basement membrane via hemidesmosomes and basement membrane complexes.

What is EBMD in medical terms?

Epithelial basement membrane dystrophy (EBMD) is characterized by abnormal quantities of basement membrane and cytoplasmic debris that are misdirected into the corneal epithelium. Clinically, the abnormal deposits in EBMD appear as dot-like opacities, map-like patterns, or whorled fingerprint-like lines in the corneal epithelium. In many patients, the epithelial lesions change in appearance, location and number over time.

What is differential diagnosis?

Differential diagnoses would include any diseases that present with corneal opacities or epithelial damage.

What is the pathophysiology of EBMD?

It should be noted that the underlying pathophysiology of EBMD lies in the basement membrance. Simple debridement of the epithelium does little to solve this problem, more likely just resetting the clock for future epithelial breakdown. Polishing the basement membrane with a diamond burr or photoablative removal of the defective basement membrane will produce far more effective and longer lasting benefits.

Is EBMD a degenerative disorder?

In the vast majority of patients, EBMD is thought to be a degenerative disorder rather than a corneal dystrophy.

What are the extra sheets of the basement membrane?

In EBMD, extra sheets of basement membrane extend, abnormally, into the corneal epithelium (presenting as "maps"). Maturing epithelial cells migrating towards the anterior surface of the epithelium become entrapped in these extra sheets and form cysts (or "dots"). Parallel or concentric lines of thickened basement membrane present as "fingerprints." These abnormalities within the epithelium may cause blurred vision. Abnormalities of the basement membrane may interfere with adherence of the epithelial cells to the basement membrane and lead to painful recurrent corneal erosions.

What is EBMD in medical terms?

Epithelial basement membrane dystrophy (EBMD) is a disease that affects the anterior cornea, causing characteristic slit lamp findings which may result in decreased vision and/or recurrent corneal erosions. There is actually some debate as to whether EBMD is a true dystrophy (a disease which occurs more commonly within affected families than in ...

What is the differential diagnosis for corneal erosion?

The differential cause of recurrent corneal erosions includes corneal abrasion. HSV or HZV keratitis might cause sub-epithelial/anterior stromal scarring or epithelial defects that could be confused for EBMD associated scarring or erosions.

What are the risk factors for EBMD?

Risk Factors. Known family history and age are probably the most important risk factors for EBMD. There are no known controllable risk factors. Risk factors for progression or exacerbation of the disease include trauma such as corneal abrasion, LASIK, or other intraocular surgery.

Is EBMD a disease?

There is actually some debate as to whether EBMD is a true dystrophy (a disease which occurs more commonly within affected families than in the general population) or a corneal degeneration (a disease which more commonly occurs randomly than in affected families).

Is EBMD autosomal dominant?

Although most patients do not seem to be aware of a family history, there are autosomal dominant pedigrees of EBMD that have been described. Certain point mutations in the TGFBI gene on chromosome 5 may be responsible for some EBMD cases.

Can EBMD be prevented?

There is no real prevention for EBMD. If recurrent cornea erosions are present with the EBMD, they may be prevented with nighttime lubricating or hypertonic saline ointments or with various surgical procedures described below and in the eyewiki article "Anterior Stromal Puncture."

Clinical significance

  • Anterior Basement Membrane Corneal Dystrophy is the official name for Map Dot Fingerprint Corneal Dystrophy. In this condition, the basement membrane under the corneal epithelium does not function properly. The basement membrane functions as a sticky anchor over which the epithelium grows. The basement membrane stabilizes the epithelium. There are ...
See more on westmetroeye.com

Symptoms

  • Most patients who have ABMD dont have any symptoms. However, when the basement membrane doesnt stabilize the epithelium properly, two sets of symptoms may occur.
See more on westmetroeye.com

Mechanism of action

  • PTK involves the removal of a small amount of corneal tissue with the excimer laser. This creates a rougher surface for epithelial cells to adhere to, thus decreasing the chance of erosions. The excimer laser is the same laser used for LASIK and PRK. On occasion one can combine PTK with PRK to treat refractive errors at the same time; however, the additional treatment is not covered …
See more on westmetroeye.com

Treatment

  • When undergoing PTK, the epithelium is removed before treatment. During the 4-6 days it takes for the epithelium to regrow, the eye will be uncomfortable. Drops will be given to promote healing and lessen pain, and a bandage contact lens will be placed for comfort during that week. PTK for recurrent erosion is usually successful, but there are expected side effects and possible risks. It …
See more on westmetroeye.com

Diagnosis

  • More information on this condition can be found at the National Eye Institutes website, under the corneal section.
See more on westmetroeye.com