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[Corneal ulcers in systemic autoimmunologic diseases]
R Augsten1, J Dawczynski, U Voigt
1Klinik für Augenheilkunde, Universitätsklinikum Jena, Bachstrasse 18, Jena. Regine.Augsten@med.uni-jena.de
Klinische Monatsblatter Fur Augenheilkunde
|August 18, 2010
Summary
Autoimmune diseases like rheumatoid arthritis can cause severe corneal ulcers, often leading to poor vision. Intensive treatment offers limited improvement, highlighting the need for lifelong immunosuppression to preserve sight.
Area of Science:
- Ophthalmology
- Rheumatology
- Immunology
Background:
- Corneal ulcers are a rare but severe complication of systemic autoimmune diseases.
- Prognosis for these ulcers remains poor despite complex therapeutic interventions.
Observation:
- A study cohort included seven patients (10 eyes) aged 45-73 with corneal ulcers, often perforated, linked to rheumatoid arthritis or Sjögren's syndrome.
- Initial visual acuity varied significantly based on ulcer perforation status.
Findings:
- Surgical interventions (conjunctival plasty, keratoplasty) combined with local and systemic immunosuppressive therapy were employed.
- Despite treatment, visual acuity remained significantly impaired in eyes with perforated ulcers, with some cases requiring evisceration.
- Eyes with non-perforated ulcers showed better visual outcomes with combined therapies.
Implications:
- Corneal ulcers associated with autoimmune conditions pose a significant risk of vision loss, even with aggressive treatment.
- Lifelong systemic immunosuppressive therapy is crucial for managing these conditions and preserving vision in the affected eye.
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