We read with great interest the article by Gutiérrez Gutiérrez et al.1 on the diagnosis and follow-up of patients with myotonic dystrophy.
We are sure that this comprehensive study will be extremely useful for all physicians.
We would like to contribute additional information on ophthalmological findings associated with the disease.
The authors rightly focus on the importance of detecting low intraocular pressure, and underscore the importance of ultrasound in detecting the cause of this and other pathological findings.2–5
However, other studies into the ophthalmological features of myotonic dystrophy report an association with Fuchs endothelial dystrophy6,7 and eye melanoma.8,9
Furthermore, the authors focus on the prevalence of cataracts in these patients, and suggest the possibility of cataract removal in the event of decreased visual acuity.10–12
If cataract surgery is considered, a study of endothelial cells should be performed not only to gather clinical data with a view to preventing corneal endothelial decompensation, but also because the available evidence provides conflicting information on the possible association between myotonic dystrophy and Fuchs endothelial dystrophy.13–15
Lastly, regarding the association between myotonic dystrophy and eye melanoma, a thorough eye fundus examination should be performed in these patients to ensure early detection of this potentially fatal condition.
FundingThis study has received no funding from any public, private, or non-profit organisation.
Please cite this article as: Vitiello L, Politano L, De Bernardo M, Rosa N. Implicación ocular en pacientes con distrofia miotónica. Neurología. 2020;35:674–675.