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[Peripheral ulcerative keratitis in a 24-year-old patient].

J S Steinberg¹, M C Herwig, F G Holz

¹Universitäts-Augenklinik Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Deutschland, julia.steinberg@ukb.uni-bonn.de.

Der Ophthalmologe : Zeitschrift Der Deutschen Ophthalmologischen Gesellschaft

|September 19, 2013

Summary

Mooren's ulcer, a rare corneal disease, can lead to rapid melting and perforation. Early diagnosis and aggressive immunosuppressive therapy are crucial for managing this severe condition.

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Area of Science:

Ophthalmology
Corneal Diseases
Immunosuppression

Background:

Mooren's ulcer is a rare, progressive ulcerative condition affecting the peripheral cornea.
This case highlights the challenges in managing rapidly progressing Mooren's ulcer, particularly in young patients.

Observation:

A 24-year-old female presented with severe corneal melting and defect, initially suspected as Mooren's ulcer.
Despite intensive medical treatment, the ulcer perforated, necessitating emergency corneal transplantation (keratoplasty).

Findings:

Histological examination revealed a distinct demarcation line in the melting cornea with limbal inflammation.
Both eyes eventually required keratoplasty due to progressive ulceration and perforation despite aggressive immunosuppressive therapy (Cellcept, cyclosporin, methotrexate).

Implications:

Aggressive and long-term immunosuppression is vital for preventing recurrence and progression of Mooren's ulcer.
This case underscores the need for prompt diagnosis and multidisciplinary management, including immunosuppressive agents and surgical intervention, for sight-threatening corneal ulcers.