Peripheral Ulcerative Keratis: Importance Of Intensive And Early Management

Assess the diagnostic and therapeutic management in patients with peripheral ulcerative keratitis (PUK).

Hospital General Universitario Gregorio Marañón, Madrid, Spain.

Descriptive retrospective study where the cases of peripheral ulcerative keratitis that come to our center since 2017 are analyzed. Their etiology, local and systemic personal history, previous surgeries, clinical and topographic characteristics and previous treatments are analyzed. Time to diagnosis, initiation of treatment, recurrence episodes, control of ocular inflammation and underlying disease, visual acuity and complications are also analyzed

Five cases of patients were presented. Age; 66±14.6 years. In all cases there was a systemic underlying autoimmune pathology diagnosed after the ophthalmological diagnosis. The time from presentation to treatment was 15 ± 18.9 months. In 2 cases where immunomodulatory treatment was started later (17, 51 months), keratoplasty was required to control progressive thinning. In all patients, after the establishment of immunomodulatory treatment, clinical improvement without progression of the disease and no relapses or rejections of the transplants performed are described. Improvement in visual acuity was statistically significant after treatment ( p< 0,05). Only one complication of treatment was found.

Given the suspicion of peripheral ulcerative keratitis, systemic autoimmune disease and infections should be ruled out in order to establish immunomodulatory treatment early. The early establishment of immunomodulatory treatment is related to a better prognosis.