Posters

The complete success in refractory Mooren’s ulcer treated with Infliximab

Poster Details

First Author: N.Yildirim TURKEY

Co Author(s):    A. Cakmak   Y. Akova                 

Abstract Details

Purpose:

To present two bilateral progressive Mooren’s ulcer cases treated successfully with Infliximab, an anti-tumour necrosis factor alpha(TNF-α) agent

Setting:

Eskisehir Osmangazi University, Medical School , Department of Ophthalmology

Methods:

Two female patients aged 47 and 75 presented with bilateral blurred vision and severe pain. Biomicroscopy revealed hyperemia and peripheral ulcerative keratitis in both eyes. Despite the conventional immunosuppressant therapy(topical and systemic), patients showed an increase both in complaints and progressive bilateral recurrent ulcers that required melting tectonic grafts. Treatment with Infliximab,an anti-TNF-α agent, was initiated to these cases of Mooren's ulcer.

Results:

Following injections of monthly doses of Infliximab, 6 times to 47 year-old patient and 3 times to 75 year-old patient, eyes showed a marked reduction both in pain and corneal inflammation. Ocular manifestations were stabilized and no progression of corneascleral thinning was observed during the 3-year follow-up.

Conclusions:

Mooren's ulcer is a rare, severe uni-or bilateral peripheral corneal ulcer. It is hard to treat sometimes with conventional immunosuppressive therapy. In the management of the Mooren’s Disease, the aim is to inhibit the TNF-α which is one of the important inflammatory cytokines that induces inflammation and metalloproteinases leading to a corneascleral dissolution.  Infliximab, an anti-TNF-α agent, is approved by FDA in some autoimmune diseases, can also be used in peripheral corneal keratitis, in Mooren’s disease, as an effective approach to cases which are refractory to immunosuppressant therapies. 

Financial Disclosure:

NONE