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Published on: August 2, 2024
[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.
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.
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.
