Posters

Peripheral ulcerative keratitis in patient with rheumatoid arthritis: case report

Poster Details

First Author: V.Reci MACEDONIA

Co Author(s):    H. Duma                    

Abstract Details

Purpose:

Peripheral ulcerative keratitis is a complication of autoimmune disorders, espacially collagen vascular disorders which can lead to rapid peripheral corneal thinning and perforation with loss of vision. In the most of cases correlates with exacerbations of the autoimmune diseases. It may be associated with scleritis, more frequently with necrotizant form.

Setting:

University Clinic for Eye Diseases, Skopje, Republic of North Macedonia.

Methods:

our patient came at our office because of ocular pain, redness, tearing, photophobia, foreign body sensation and decreased vision. Past medical history: rheumatoid arthtritis since 5 years. No family history of autoimmune diseases. Exam: VA without correction: 20/200; IOP: 18 mmHg; Meibomian gland dysfunction, conjunctival hyperemia, peripheral ulcerative keratitis between 3:00 and 7:00 with epithelial defect and stromal thining: anterior chamber: 3+ cell; pupil:equal and round with light response and acomodation; fundus exam normal.

Results:

We have treated with topical moxifloxacine and tobramicyn, lubrificants, bandage soft contact lens to treat associated dry eye and promote epithelialization of the ulcer; and sistemic therapy with methylprednisone 1mg/kg/day for 3 days and than 60mg oral steroids for 2 weeks than tapered over several months; also methotrexate 20mg/weekly with blood monitoring. The eye was saved from corneal perforation but with permanent corneal scarring.

Conclusions:

The first-line of treatment in acute phases is represented by systemic administration of corticosteroids, immunosuppressive and cytotoxic agents that are necessary for the treatment of peripheral ulcerative keratitis associated with systemic diseases.

Financial Disclosure:

None