Interventions for Mooren's ulcer

Alhassan, Mahmoud B; Rabiu, Mansur; Agbabiaka, Idris O

doi:10.1002/14651858.cd006131.pub3

Cited by 23 publications

(30 citation statements)

References 30 publications

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“…Grafted eyes had a stromal infiltration beyond stromal melt that resolved after rituximab infusion. A good medical control of the disease is mandatory for graft survival in severe cases with corneal perforation to avoid graft melt 6 7. We acknowledge that this small case series requires further studies to confirm the efficacy of rituximab.…”

Section: Discussionmentioning

confidence: 85%

“…To our knowledge, this is the first evaluation of the use of rituximab in the treatment of aggressive Mooren's ulcer. Surgical and medical management of Mooren's ulcer is challenging and without consensus 6. The most commonly used local treatments are corticosteroids3 and ciclosporin A 2% 8.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, anti-tumour necrosis factor agents were effective in a case report 10 11. For severe cases, cyclophosphamide is recommended as the first-line treatment in association with conjunctival resection, cyanoacrylate application or lamellar keratoplasty6 in order to avoid the occurrence of perforation 3. In the present series, before rituximab initiation all patients had severe progressive corneal melt leading to corneal perforation (in 5/6 affected corneas) despite local and systemic immunosuppressive therapies, conjunctival resection and amniotic membrane graft (6/6 affected corneas).…”

Section: Discussionmentioning

confidence: 99%

“…Among surgical procedures that could be performed in the course of Mooren's ulcer, none are performed without local and/or systemic immunosuppression. The goal of conjunctival resection is to prevent immune cell infiltration 6. Keratoplasty is performed for severe corneal thinning or perforation in association with immunosuppression; uncontrolled Mooren's inflammation leads to graft melt 7.…”

Section: Introductionmentioning

confidence: 99%

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Management of severe and refractory Mooren's ulcers with rituximab

et al. 2016

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Management of severe and refractory Mooren's ulcers with rituximab

et al. 2016

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“…Mooren's ulcer is a severe, painful, ulcerative, uni- or bilateral inflammation of the cornea, and is commonly seen in China 1. The ulcer typically starts at the peripheral cornea and enlarges centrally and circumferentially 2.…”

Section: Introductionmentioning

confidence: 99%

Modified lamellar keratoplasty and immunosuppressive therapy guided by in vivo confocal microscopy for perforated Mooren's ulcer

Liu

Shi

et al. 2015

Br J Ophthalmol

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Reliability of the Evidence Addressing Treatment of Corneal Diseases

et al. 2019

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IMPORTANCE Patient care should be informed by clinical practice guidelines, which in turn should be informed by evidence from reliable systematic reviews. The American Academy of Ophthalmology is updating its Preferred Practice Patterns (PPPs) for the management of the following 6 corneal diseases: bacterial keratitis, blepharitis, conjunctivitis, corneal ectasia, corneal edema and opacification, and dry eye syndrome. OBJECTIVE To summarize the reliability of the existing systematic reviews addressing interventions for corneal diseases. DATA SOURCE The Cochrane Eyes and Vision US Satellite database. STUDY SELECTION In this study of published systematic reviews from 1997 to 2017 (median, 2014), the Cochrane Eyes and Vision US Satellite database was searched for systematic reviews evaluating interventions for the management of any corneal disease, combining eyes and vision keywords and controlled vocabulary terms with a validated search filter. DATA EXTRACTION AND SYNTHESIS The study classified systematic reviews as reliable when each of the following 5 criteria were met: the systematic review specified eligibility criteria for inclusion of studies, conducted a comprehensive literature search for studies, assessed risk of bias of the individual included studies, used appropriate methods for quantitative syntheses (meta-analysis) (only assessed if meta-analysis was performed), and had conclusions that were supported by the results of the systematic review. They were classified as unreliable if at least 1 criterion was not met. MAIN OUTCOMES AND MEASURES The proportion of systematic reviews that were reliable and the reasons for unreliability. RESULTS This study identified 98 systematic reviews that addressed interventions for 15 corneal diseases. Thirty-three of 98 systematic reviews (34%) were classified as unreliable. The most frequent reasons for unreliability were that the systematic review did not conduct a comprehensive literature search for studies (22 of 33 [67%]), did not assess risk of bias of the individual included studies (13 of 33 [39%]), and did not use appropriate methods for quantitative syntheses (meta-analysis) (12 of 17 systematic reviews that conducted a quantitative synthesis [71%]). Sixty-five of 98 systematic reviews (66%) were classified as reliable. Forty-two of the 65 reliable systematic reviews (65%) addressed corneal diseases relevant to the 2018 American Academy of Ophthalmology PPPs; 33 of these 42 systematic reviews (79%) are cited in the 2018 PPPs. CONCLUSIONS AND RELEVANCE One in 3 systematic reviews addressing interventions for corneal diseases are unreliable and thus were not used to inform PPP recommendations. Careful adherence by systematic reviewers and journal editors to well-established best practices regarding systematic review conduct and reporting might help make future systematic reviews in eyes and vision more reliable.

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Interventions for Mooren's ulcer

Cited by 23 publications

References 30 publications

Management of severe and refractory Mooren's ulcers with rituximab

Management of severe and refractory Mooren's ulcers with rituximab

Modified lamellar keratoplasty and immunosuppressive therapy guided by in vivo confocal microscopy for perforated Mooren's ulcer

Reliability of the Evidence Addressing Treatment of Corneal Diseases

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