J Korean Ophthalmol Soc.  2011 Aug;52(8):936-942. 10.3341/jkos.2011.52.8.936.

The Clinical Manifestations and Prognostic Factors of Autoimmune-Related Peripheral Corneal Ulcers

• Ma DJ
• Choi HJ
• Kim MK
• Wee WR

• KMID: 2214770
• DOI: http://doi.org/10.3341/jkos.2011.52.8.936

Abstract

PURPOSE
To investigate clinical manifestations and prognostic factors of autoimmune-related peripheral corneal ulcers.
METHODS
Nineteen eyes in 18 patients who were diagnosed with autoimmune-related peripheral corneal ulcer from November 1999 to August 2010 were enrolled in the present study. Clinical manifestations and treatment results were investigated retrospectively.
RESULTS
The average age at presentation was 64.6 years with female (66.7%) and unilateral (94.4%) dominance. The main etiologies were Mooren's ulcer (53.6%) and rheumatoid arthritis (26.3%). The ulcer depth was greater than 75% of the corneal thickness in more than half of the cases (57.9%) and the mean extent of the ulcer was 69.5degrees. There were no significant improvements in visual acuity after treatment (p = 0.789) and no significant differences in treatment outcomes among etiologies or treatment modalities. The patients who underwent ulcer recurrence (p = 0.048) or treatment failure (p = 0.005) had poorer final visual acuity than those patients who did not. The ulcer depth correlated with treatment failure (p = 0.037). The final visual acuity showed positive correlations with visual acuity at presentation (p = 0.031) and negative correlations with the number of recurrences (p = 0.042).
CONCLUSIONS
The visual acuity at presentation and ulcer depths were significant prognostic factors. These factors appeared to be helpful in the treatment of marginal keratitis depending on the depth of the ulcer.

Keyword

Autoimmune; Connective tissue disease; Mooren's ulcer; Peripheral corneal ulcer; Recurrence; Treatment failure

MeSH Terms

Arthritis, Rheumatoid
Connective Tissue Diseases
Corneal Ulcer
Eye
Female
Humans
Keratitis
Recurrence
Treatment Failure
Ulcer
Visual Acuity

Figure

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  Figure 1. Corneal ulcer extent. The angle between the two margins of the corneal ulcer (degree).

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  Figure 2. Comparison of final acuity for recurrence or treatment failure. Statistics were analyzed by Mann-Whitney U-test. * p = 0.048; † p = 0.005.

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