Biologics in peripheral ulcerative keratitis.

Area of Science:

• Ophthalmology
• Rheumatology
• Immunology

Background:

• Biologic therapies have become crucial in managing ocular inflammation over the last 20 years.
• Peripheral ulcerative keratitis (PUK) is a severe ocular condition often associated with systemic rheumatological diseases.
• Historically, PUK posed a significant risk of blindness and mortality, but newer treatments are emerging.

Purpose of the Study:

• To review the existing evidence for using biologic therapies in managing peripheral ulcerative keratitis (PUK).
• To provide guidance on the clinical application, including dosage and adverse effects, of biologics for PUK.
• To assess the efficacy of biologics in refractory cases of PUK.

Main Methods:

• A comprehensive literature search was conducted across major databases: Medline, Embase, and Cochrane Database of Systematic Reviews.
• The search focused on identifying peer-reviewed articles detailing the treatment of PUK patients with biologic agents.
• Case reports and series were analyzed to gather data on treatment outcomes and adverse events.

Main Results:

• The overall evidence base for biologic use in PUK is currently limited.
• However, reported cases indicate that biologics are increasingly effective in managing refractory PUK.
• Rituximab demonstrated particular efficacy in PUK secondary to granulomatous with polyangiitis.

Conclusions:

• Biologic therapies represent a powerful and effective treatment option for patients with refractory PUK.
• Further research is needed to strengthen the evidence base, but current data support their use.
• Clinical guidelines for the use of biologics in PUK are emerging, with specific considerations for agents like rituximab.