Paracentral Rheumatoid Corneal Ulceration: Clihical Features and Cyclosporine Therapy

Gerard N. Kervick, Stephen C. Pflugfelder, Robert Haimovici, Harvey Brown, Elaine Tozman, Richard Yee

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Abstract

Six patients with rheumatoid arthritis (eight eyes) presented with small paracentral perforating corneal ulcers in otherwise quiet eyes. Initial management in five patients (seven eyes) consisted of systemic immunosuppression and therapeutic tissue adhesive with a bandage contact lens or tectonic keratoplasty. Ulceration recurred in all of these eyes, and recurrent ulcers treated with repeat tectonic keratoplasty or therapeutic tissue adhesive and a bandage contact lens all developed recurrent ulceration. The introduction of topical cyclosporine therapy in five eyes with recurrent corneal ulceration was associated with arrest of keratolysis and rapid re-epithelialization of the ulcer in all cases. One corneal ulcer was successfully treated initially with topical cyclosporine, tissue adhesive, and a bandage contact lens. In patients with rheumatoid arthritis and small paracentral corneal ulcerations or perforations, application of tissue adhesive and a bandage contact lens and introduction of topical cyclosporine may be the preferred initial treatment.

Original languageEnglish (US)
Pages (from-to)80-88
Number of pages9
JournalOphthalmology
Volume99
Issue number1
DOIs
StatePublished - Jan 1 1992

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ASJC Scopus subject areas

  • Ophthalmology

Cite this

Kervick, G. N., Pflugfelder, S. C., Haimovici, R., Brown, H., Tozman, E., & Yee, R. (1992). Paracentral Rheumatoid Corneal Ulceration: Clihical Features and Cyclosporine Therapy. Ophthalmology, 99(1), 80-88. https://doi.org/10.1016/S0161-6420(92)32006-8