Posters

Bilateral peripheral ulcerative keratitis revealing rheumatoid arthritis

Poster Details

First Author: S.Bajjouk MOROCCO

Co Author(s): M. Bouchaar   J. Brahim Salem   M. Belmalih   K. Reda   A. Oubaaz        

Abstract Details

Purpose:

Sterile corneal ulcers resulting from rheumatoid arthritis are rare and can take many forms, predominately affecting the peripheral cornea. They correspond to marginal ulcers most often of autoimmune origin We report of a rare case of inaugural ocular manifestation of rheumatoid arthritis

Setting:

Cheikh Khalifa Bin Zayed International University Hospital, Casablanca

Methods:

A 64-year-old female patient  who presented to the emergency department for bilateral eye pain associated with blurring of vision and photophobia for 5 days. On examination, she had visual acuity of 5/10 in the right eye and 7/10 in the left eye.

Results:

The slit lamp examination revealed a bilateral sterile corneal ulcer, parallel to the limb, pre-perforating, more accentuated in the right eye; associated with a scleritis; and superficial punctate keratitis The Schirmer test revealed a severe dry eye syndrome. The interrogation found the notion of inflammatory joint pain, and Laboratory investigations revealed a high level of anti-rheumatoid factor and anti-CCP antibodies. 
The diagnosis of rheumatoid arthritis was retained The patient was treated with immunosuppressive therapy; after agreement of the internist,combined with corticosteroids (topical and subconjunctival injections), and lubricants (topical and gel) Re-epithelization occurred 2 weeks after initiation of the immunosuppressive treatment.

Conclusions:

The presence of an aseptic peripheral corneal ulcer without infiltrate should evoke an inflammatory origin related to a systemic disease, in particular rheumatoid arthritis. Adequate care is essential to avoid complications that are particularly severe

Financial Disclosure:

None