Immunosuppression for Mooren's ulcer: evaluation of the stepladder approach—topical, oral and intravenous immunosuppressive agents

Abstract

An aggressive immunosuppressive regimen that is tailor made based on disease severity as a first line of therapy improves the chances of disease control even in cases of aggressive Mooren's ulcer.

Demographic profile, clinical features and outcome of peripheral ulcerative keratitis: a prospective study

“…Topical steroids were started in cases where the microbes were ruled out and there was no perforation 17. Topical steroids such as prednisolone acetate 1% were started in cases of PUK if the extent was less than two quadrants of involvement and/or less than 50% of stromal thickness was involved.…”

Inhibition of Interleukin-1β-Induced Matrix Metalloproteinase Expression in Human Corneal Fibroblasts by Tranilast

“…Steroid administration is effective for the treatment of some cases of corneal ulceration, such as Mooren's ulcer 42 and corneal ulcers associated with rheumatoid arthritis. 43 The long-term use of topical corticosteroids is limited, however, by potentially sight-threatening side effects such as glaucoma and cataract.…”

Interplay of Immune Cells in Mooren Ulcer

“…19 Despite intensive treatment with these conventional immunosuppressants, Mooren ulcer progresses, and corneal perforation develops in 11% to 13.3% of patients. 4,5 Given the observations made by others and us, multiple types of immune cells are involved in the pathogenesis of Mooren ulcer.…”