Severe chronic peripheral ulcerative keratitis: Approach to diagnosis and treatment

Bahloul, M. El; Lambarki, O; Bennis, Azzelarab; Chraïbi, F.; Abdellaoui, M.; Benatiya, Idriss Andaloussi

doi:10.1016/j.jfo.2020.08.017

Cited by 2 publications

(2 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…43 Peripheral ulcerative keratitis develops in chronic HCV infection, with associated necrotising scleritis being a common clinical finding. 44,45,46,47,48,49 The management of choice for HCV infection is interferon-alpha and ribavirin. 43 The patients who were refractory to this have responded well to a combination of interferon-alpha, ribavirin and rituximab.…”

Section: Hepatitis Cmentioning

confidence: 99%

Peripheral ulcerative keratitis: A review of aetiology and management

Hӧllhumer

2022

African Vision and Eye Health

View full text Add to dashboard Cite

Background: Peripheral ulcerative keratitis (PUK) is a severe inflammatory disease of the peripheral cornea that can be caused by local factors or systemic inflammatory disease.Aim: The purpose of this review is to give an overview of the pathophysiology, aetiology, clinical features, diagnosis, and management of PUK.Method: A PubMed search was conducted using the keywords, ‘peripheral ulcerative keratitis’ and ‘Mooren’s ulcer’.Results: The peripheral cornea has unique characteristics the predispose to the development of PUK. These include fine capillary arcades that allow for deposition of immune complexes and subsequent activation of an inflammatory cascade with corneal melt. Several conditions have been implicated in the aetiology of PUK. The most commonly cited causes are rheumatoid arthritis (RA), granulomatosis with polyangiitis (GPA) and various dermatoses. In patients with RA, PUK usually presents in established disease, whereas in GPA, PUK may be the presenting feature in up to 60% of cases. In RA it heralds the onset of a systemic vasculitis with significant associated morbidity and mortality. The management of PUK follows an individualised stepwise approach. All patients require supportive measures to encourage healing and halt the process of keratolysis. Systemic autoimmune conditions need a systemic corticosteroid as a fast-acting agent to halt the inflammatory process while cytotoxic therapy maintains long term disease control. Failure to achieve disease control with CTT, necessitates the use of a biologic agent.Conclusion: Peripheral ulcerative keratitis is a severe inflammatory disease of the peripheral cornea that needs a thorough diagnostic workup and stepwise management approach.

show abstract

Section: Hepatitis Cmentioning

confidence: 99%

Peripheral ulcerative keratitis: A review of aetiology and management

Hӧllhumer

2022

African Vision and Eye Health

View full text Add to dashboard Cite

show abstract

“…Peripheral ulcerative keratitis (PUK) is often defined by the clinical triad of a rapidly-progressive, crescent-shaped area of peripheral corneal thinning, an epithelial defect, and an inflammatory corneal infiltrate (Fig. 1) [1,2 ▪▪ ,3,4]. It represents the final common pathway for diverse systemic and local inflammatory conditions.…”

Section: Introductionmentioning

confidence: 99%

Peripheral ulcerative keratitis due to systemic diseases

Sura¹,

McCallum

2022

Current Opinion in Ophthalmology

View full text Add to dashboard Cite

Purpose of reviewTo discuss peripheral ulcerative keratitis, with a focus on the evaluation and management of associated systemic diseases.Recent findingsPeripheral ulcerative keratitis (PUK) is a sight-threatening condition that is often defined by the presence of a crescent-shaped area of peripheral corneal thinning, an epithelial defect, and an inflammatory corneal infiltrate. It is highly associated with rheumatoid arthritis, systemic necrotizing vasculitides like granulomatosis with polyangiitis, and collagen vascular diseases like systemic lupus erythematosus. Undertreated PUK carries a risk of vision loss and premature death.SummaryMultidisciplinary collaboration between the ophthalmologist, rheumatologist, and other consultants is required. Early and aggressive steroid-sparing therapy should be considered in cases due to noninfectious systemic disease.

show abstract

Severe chronic peripheral ulcerative keratitis: Approach to diagnosis and treatment

Cited by 2 publications

References 6 publications

Peripheral ulcerative keratitis: A review of aetiology and management

Peripheral ulcerative keratitis: A review of aetiology and management

Peripheral ulcerative keratitis due to systemic diseases

Contact Info

Product

Resources

About