Peripheral Ulcerative Keratitis Questions & Answers

1. Mondino BJ. Inflammatory diseases of the peripheral cornea. Ophthalmology. 1988 Apr. 95(4):463-72. [QxMD MEDLINE Link].

2. Shiuey Y, Foster CS. Peripheral ulcerative keratitis and collagen vascular disease. Int Ophthalmol Clin. 1998 Winter. 38(1):21-32. [QxMD MEDLINE Link].

3. Messmer EM, Foster CS. Vasculitic peripheral ulcerative keratitis. Surv Ophthalmol. 1999 Mar-Apr. 43(5):379-96. [QxMD MEDLINE Link].

4. Foster CS, Sainz de la Maza M. Immunological considerations of the sclera. Foster CS, ed. The Sclera. 1st ed. New York: Springer-Verlag; 1993:33-58.

5. Gregory JK, Foster CS. Peripheral ulcerative keratitis in the collagen vascular diseases. Int Ophthalmol Clin. 1996 Winter. 36(1):21-30. [QxMD MEDLINE Link].

6. Eiferman RA, Carothers DJ, Yankeelov JA Jr. Peripheral rheumatoid ulceration and evidence for conjunctival collagenase production. Am J Ophthalmol. 1979 May. 87(5):703-9. [QxMD MEDLINE Link].

7. Brown SI, Grayson M. Marginal furrows. A characteristic corneal lesion of rheumatoid arthritis. Arch Ophthalmol. 1968 May. 79(5):563-7. [QxMD MEDLINE Link].

8. Tauber J, Sainz de la Maza M, Hoang-Xuan T, et al. An analysis of therapeutic decision making regarding immunosuppressive chemotherapy for peripheral ulcerative keratitis. Cornea. 1990 Jan. 9(1):66-73. [QxMD MEDLINE Link].

9. Hoang-Xaun T, Foster CS, Rice BA. Scleritis in relapsing polychondritis. Response to therapy. Ophthalmology. 1990 Jul. 97(7):892-8. [QxMD MEDLINE Link].

10. Watson PG, Hazelman BC. The Sclera and Systemic Disorders. Philadelphia: WB Saunders Co; 1976. 241.

11. Sangwan VS, Zafirakis P, Foster CS. Mooren's ulcer: current concepts in management. Indian J Ophthalmol. 1997 Mar. 45(1):7-17. [QxMD MEDLINE Link].

12. Tabbara KF. Mooren's ulcer. Int Ophthalmol Clin. 1986 Winter. 26(4):91-8. [QxMD MEDLINE Link].

13. Knox Cartwright NE, Tole DM, Georgoudis P, Cook SD. Peripheral ulcerative keratitis and corneal melt: a 10-year single center review with historical comparison. Cornea. 2014 Jan. 33(1):27-31. [QxMD MEDLINE Link].

14. Mattern RM, Ding J. Keratitis with Kocuria palustris and Rothia mucilaginosa in Vitamin A Deficiency. Case Rep Ophthalmol. 2014 Jan. 5(1):72-7. [QxMD MEDLINE Link].

15. Lange AP, Moloney G, Sheldon CA, Sasaki S, Holland SP. Bilateral Corneal Ulceration Caused by Vitamin A Deficiency in Eosinophilic Gastroenteropathy. Case Report Ophthalmol. 2011 Sep. 2(3):302-306. [QxMD MEDLINE Link]. [Full Text].

16. Papathanassiou M, Zampeli E, Kaplanoglou T, Theodossiadis P. Peripheral ulcerative keratitis in a patient with systemic-onset juvenile idiopathic arthritis. J Pediatr Ophthalmol Strabismus. 2010 Oct 21. 47 Online:e1-3. [QxMD MEDLINE Link].

17. Ji YS, Yoon KC. A rare case of peripheral ulcerative keratitis associated with Behçet's disease. Int Ophthalmol. 2014 Feb 4. [QxMD MEDLINE Link].

18. Imbernón-Moya A, Vargas-Laguna E, Aguilar A, Gallego MÁ, Vergara C, Nistal MF. Peripheral Ulcerative Keratitis with Pyoderma Gangrenosum. Case Rep Dermatol Med. 2015. 2015:949840. [QxMD MEDLINE Link].

19. Papavasileiou E, Prasad S, Freitag SK, Sobrin L, Lobo AM. Ipilimumab-induced Ocular and Orbital Inflammation-A Case Series and Review of the Literature. Ocul Immunol Inflamm. 2016 Apr. 24 (2):140-6. [QxMD MEDLINE Link].

20. Iovieno A, Anand S, Dart JK. Late-onset peripheral ulcerative sclerokeratitis associated with alkali chemical burn. Am J Ophthalmol. 2014 Dec. 158 (6):1305-1309.e4. [QxMD MEDLINE Link].

21. Papaconstantinou D, Georgopoulos G, Kalantzis G, Krassas A, Georgalas I. Peripheral ulcerative keratitis after trabeculectomy in a patient with rheumatoid arthritis. Cornea. 2009 Jan. 28(1):111-3. [QxMD MEDLINE Link].

22. Kiire CA, Srinivasan S, Inglis A. Peripheral ulcerative keratitis after cataract surgery in a patient with ocular cicatricial pemphigoid. Cornea. 2011 Oct. 30(10):1176-8. [QxMD MEDLINE Link].

23. Chawla B, Agarwal P, Tandon R, et al. Peripheral ulcerative keratitis with bilateral optic nerve involvement as an initial presentation of acute lymphocytic leukemia in an adult. Int Ophthalmol. 2007 Nov 16. [QxMD MEDLINE Link].

24. Morjaria R, Barge T, Mordant D, Elston J. Peripheral ulcerative keratitis as a complication of acute myeloid leukaemia. BMJ Case Rep. 2014 Oct 31. 2014:[QxMD MEDLINE Link].

25. Carson DA. Rheumatoid factor. Kelley WN, Harris ED Jr, Ruddy S, Sledge CB, eds. Textbook of Rheumatology. 3rd ed. Philadelphia: WB Saunders Co; 1989. 664-679.

26. Lüdemann G, Gross WL. Autoantibodies against cytoplasmic structures of neutrophil granulocytes in Wegener's granulomatosis. Clin Exp Immunol. 1987 Aug. 69(2):350-7. [QxMD MEDLINE Link].

27. Savage CO, Winearls CG, Jones S, et al. Prospective study of radioimmunoassay for antibodies against neutrophil cytoplasm in diagnosis of systemic vasculitis. Lancet. 1987 Jun 20. 1(8547):1389-93. [QxMD MEDLINE Link].

28. Nolle B, Specks U, Ludemann J, et al. Anticytoplasmic autoantibodies: their immunodiagnostic value in Wegener granulomatosis. Ann Intern Med. 1989 Jul 1. 111(1):28-40. [QxMD MEDLINE Link].

29. Garg A, De Rojas J, Mathews P, Hazan A, Lin J, Trief D, et al. Using Anterior Segment Optical Coherence Tomography to Monitor Disease Progression in Peripheral Ulcerative Keratitis. Case Rep Ophthalmol Med. 2018. 2018:3705753. [QxMD MEDLINE Link].

30. Squirrell DM, Winfield J, Amos RS. Peripheral ulcerative keratitis 'corneal melt' and rheumatoid arthritis: a case series. Rheumatology (Oxford). 1999 Dec. 38(12):1245-8. [QxMD MEDLINE Link].

31. Sharma N, Sinha G, Shekhar H, Titiyal JS, Agarwal T, Chawla B, et al. Demographic profile, clinical features and outcome of peripheral ulcerative keratitis: a prospective study. Br J Ophthalmol. 2015 Nov. 99 (11):1503-8. [QxMD MEDLINE Link].

32. Liegner JT, Yee RW, Wild JH. Topical cyclosporine therapy for ulcerative keratitis associated with rheumatoid arthritis. Am J Ophthalmol. 1990 May 15. 109(5):610-2. [QxMD MEDLINE Link].

33. Miyazaki D, Tominaga T, Kakimaru-Hasegawa A, et al. Therapeutic effects of tacrolimus ointment for refractory ocular surface inflammatory diseases. Ophthalmology. 2008 Jun. 115(6):988-992.e5. [QxMD MEDLINE Link].

34. Chen J, Xie H, Wang Z, et al. Mooren's ulcer in China: a study of clinical characteristics and treatment. Br J Ophthalmol. 2000 Nov. 84(11):1244-9. [QxMD MEDLINE Link].

35. Clewes AR, Dawson JK, Kaye S, et al. Peripheral ulcerative keratitis in rheumatoid arthritis: successful use of intravenous cyclophosphamide and comparison of clinical and serological characteristics. Ann Rheum Dis. 2005 Jun. 64(6):961-2. [QxMD MEDLINE Link].

36. Thomas JW, Pflugfelder SC. Therapy of progressive rheumatoid arthritis-associated corneal ulceration with infliximab. Cornea. 2005 Aug. 24(6):742-4. [QxMD MEDLINE Link].

37. Atchia II, Kidd CE, Bell RW. Rheumatoid arthritis-associated necrotizing scleritis and peripheral ulcerative keratitis treated successfully with infliximab. J Clin Rheumatol. 2006 Dec. 12(6):291-3. [QxMD MEDLINE Link].

38. Pham M, Chow CC, Badawi D, Tu EY. Use of infliximab in the treatment of peripheral ulcerative keratitis in Crohn disease. Am J Ophthalmol. 2011 Aug. 152(2):183-188.e2. [QxMD MEDLINE Link].

39. Korsten P, Bahlmann D, Patschan SA. Rapid healing of peripheral ulcerative keratitis in rheumatoid arthritis with prednisone, methotrexate and adalimumab combination therapy. Rheumatology (Oxford). 2017 Jul 1. 56 (7):1094. [QxMD MEDLINE Link].

40. Huerva V, Sanchez MC, Traveset A, Jurjo C, Ruiz A. Rituximab for peripheral ulcerative keratitis with wegener granulomatosis. Cornea. 2010 Jun. 29(6):708-10. [QxMD MEDLINE Link].

41. Albert M, Beltrán E, Martínez-Costa L. [Rituximab in rheumatoid arthritis-associated peripheral ulcerative keratitis]. Arch Soc Esp Oftalmol. 2011 Apr. 86(4):118-20. [QxMD MEDLINE Link].

42. Ebrahimiadib N, Modjtahedi BS, Roohipoor R, Anesi SD, Foster CS. Successful Treatment Strategies in Granulomatosis With Polyangiitis-Associated Peripheral Ulcerative Keratitis. Cornea. 2016 Nov. 35 (11):1459-1465. [QxMD MEDLINE Link].

43. Lambiase A, Sacchetti M, Sgrulletta R, et al. Amniotic membrane transplantation associated with conjunctival peritomy in the management of Mooren's ulcer: a case report. Eur J Ophthalmol. 2005 Mar-Apr. 15(2):274-6. [QxMD MEDLINE Link].

44. Prabhasawat P, Tesavibul N, Komolsuradej W. Single and multilayer amniotic membrane transplantation for persistent corneal epithelial defect with and without stromal thinning and perforation. Br J Ophthalmol. 2001 Dec. 85(12):1455-63. [QxMD MEDLINE Link].

45. Shimmura S, Shimazaki J, Ohashi Y, Tsubota K. Antiinflammatory effects of amniotic membrane transplantation in ocular surface disorders. Cornea. 2001 May. 20(4):408-13. [QxMD MEDLINE Link].

46. Tseng SC. Amniotic membrane transplantation for persistent corneal epithelial defect. Br J Ophthalmol. 2001 Dec. 85(12):1400-1. [QxMD MEDLINE Link].

47. Jia Y, Gao H, Li S, Shi W. Combined anterior chamber washout, amniotic membrane transplantation, and topical use of corticosteroids for severe peripheral ulcerative keratitis. Cornea. 2014 Jun. 33 (6):559-64. [QxMD MEDLINE Link].

48. Gao H, Wang X, Echegaray JJ, Li S, Wang T, Shi W. Partial lamellar keratoplasty for peripheral corneal disease using a graft from the glycerin-preserved corneoscleral rim. Graefes Arch Clin Exp Ophthalmol. 2014 Jun. 252 (6):963-8. [QxMD MEDLINE Link].

49. Jia Y, Gao H, Li S, Shi W. Combined Anterior Chamber Washout, Amniotic Membrane Transplantation, and Topical Use of Corticosteroids for Severe Peripheral Ulcerative Keratitis. Cornea. 2014 Apr 23. [QxMD MEDLINE Link].

50. Bullen CL, Liesegang TJ, McDonald TJ, et al. Ocular complications of Wegener's granulomatosis. Ophthalmology. 1983 Mar. 90(3):279-90. [QxMD MEDLINE Link].

51. Foster CS, Forstot SL, Wilson LA. Mortality rate in rheumatoid arthritis patients developing necrotizing scleritis or peripheral ulcerative keratitis. Effects of systemic immunosuppression. Ophthalmology. 1984 Oct. 91(10):1253-63. [QxMD MEDLINE Link].

52. Jabs DA, Rosenbaum JT, Foster CS, et al. Guidelines for the use of immunosuppressive drugs in patients with ocular inflammatory disorders: recommendations of an expert panel. Am J Ophthalmol. 2000 Oct. 130(4):492-513. [QxMD MEDLINE Link].

53. Robin JB, Schanzlin DJ, Verity SM, et al. Peripheral corneal disorders. Surv Ophthalmol. 1986 Jul-Aug. 31(1):1-36. [QxMD MEDLINE Link].

54. Watson PG, Hayreh SS. Scleritis and episcleritis. Br J Ophthalmol. 1976 Mar. 60(3):163-91. [QxMD MEDLINE Link].

Ellen N Yu-Keh, MD Consulting Staff, Department of Ophthalmology, St Luke's Medical Center, Quezon City, Philippines

Ellen N Yu-Keh, MD is a member of the following medical societies: Philippine Medical Association

Disclosure: Nothing to disclose.

C Stephen Foster, MD, FACS, FACR, FAAO, FARVO Clinical Professor of Ophthalmology, Harvard Medical School; Consulting Staff, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary; Founder and President, Ocular Immunology and Uveitis Foundation, Massachusetts Eye Research and Surgery Institution

C Stephen Foster, MD, FACS, FACR, FAAO, FARVO is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Association of Immunologists, American College of Rheumatology, American College of Surgeons, American Federation for Clinical Research, American Medical Association, American Society for Microbiology, American Uveitis Society, Association for Research in Vision and Ophthalmology, Massachusetts Medical Society, Royal Society of Medicine, Sigma Xi, The Scientific Research Honor Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Aldeyra Therapeutics (Lexington, MA); Bausch & Lomb Surgical, Inc (Rancho Cucamonga, CA); Eyegate Pharma (Waltham, MA); Novartis (Cambridge, MA); pSivida (Watertown, MA); Xoma (Berkeley, CA); Allakos (Redwood City, CA)<br/>Serve(d) as a speaker or a member of a speakers bureau for: Alcon (Geneva, Switzerland); Allergan (Dublin, Ireland); Mallinckrodt (Staines-upon-Thames, United Kingdom)<br/>Received research grant from: Alcon; Aldeyra Therapeutics; Allakos Pharmaceuticals; Allergan; Bausch & Lomb; Clearside Biomedical; Dompé pharmaceutical; Eyegate Pharma; Mallinckrodt pharmaceuticals; Novartis; pSivida; Santen; Aciont<br/>Stock for: Eyegate Pharma.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Christopher J Rapuano, MD Professor, Department of Ophthalmology, Sidney Kimmel Medical College of Thomas Jefferson University; Director of the Cornea Service, Wills Eye Hospital

Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Ophthalmological Society, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, Cornea Society, Eye Bank Association of America, International Society of Refractive Surgery

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: AAO; OMIC; American Society of Ophthalmic Trauma (ASOT); Avellino, Baxis; Bio-Tissue; Celularity; Dompe; Emmecell; Glaukos; Kala; Oyster Point; Sun Ophthalmics; Tarsus; TearLab<br/>Serve(d) as a speaker or a member of a speakers bureau for: Glaukos; Dompe; Bio-Tissue<br/>Received research grant from: Glaukos<br/>Received income in an amount equal to or greater than $250 from: AAO; OMIC; Baxis; Bio-Tissue; Cellularity; Dompe; Glaukos; Kala; Sun Ophthalmics; TearLab<br/>stock options for: RPS, Fount Bio.

Andrew A Dahl, MD, FACS Assistant Professor of Surgery (Ophthalmology), New York College of Medicine (NYCOM); Director of Residency Ophthalmology Training, The Institute for Family Health and Mid-Hudson Family Practice Residency Program; Staff Ophthalmologist, Telluride Medical Center

Andrew A Dahl, MD, FACS is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, American Intraocular Lens Society, American Medical Association, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, Medical Society of the State of New York, New York State Ophthalmological Society, Outpatient Ophthalmic Surgery Society

Disclosure: Nothing to disclose.

Fernando H Murillo-Lopez, MD Senior Surgeon, Unidad Privada de Oftalmologia CEMES

Fernando H Murillo-Lopez, MD is a member of the following medical societies: American Academy of Ophthalmology

Disclosure: Nothing to disclose.

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author, Lijing Yao, MD, to the development and writing of this article.

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