Barbosa-Cobos RE, De Anda-Turati AM, Lugo-Zamudio GE, De la Torre-González CE

Language: Spanish
References: 22
Page: 195-201
PDF size: 308.65 Kb.

ABSTRACT

Background: Peripheral ulcerative keratitis is a severe extraarticular manifestation of rheumatoid arthritis. Objective: To identify the prevalence of peripheral ulcerative keratitis in a Mexican population with rheumatoid arthritis and describe the clinical characteristics of the cases. Method: Observational, cross-sectional and retrolective study. The clinical files were reviewed of 231 patients with rheumatoid arthritis from the ABC Medical Center and Hospital Juárez de México who evaluated by a rheumatologist and an ophthalmologist. The prevalence of the peripheral ulcerative keratitis in rheumatoid arthritis patients was calculated. The clinical characteristics, treatment and ocular outcome of the patients with peripheral ulcerative keratitis were described. Results: Three cases of peripheral ulcerative keratitis were identified; 100% were female; age, 46.67 (SD ± 7.3) years old. The prevalence of peripheral ulcerative keratitis in rheumatoid arthritis was 1.29%. The evolution time between the diagnosis of rheumatoid arthritis and that of peripheral ulcerative keratitis was 14.33 (SD ± 7.31) years. All patients demonstrated joint activity upon diagnosis of peripheral ulcerative keratitis; 66% were treated with disease modifying antirheumatic drugs; 100% had erosions, high positive rheumatoid factor, and high positive anti-cyclic citrullinated peptide antibodies; 66% had other extraarticular manifestations, and 66% bilateral peripheral ulcerative keratitis. All were treated with conservative-free topical lubricant, systemic glucocorticoids, and immunosuppressive drugs. Sixty-six percent presented a clinical picture of ocular reactivation, and 33% corneal melt requiring surgical intervention without achieving vision preservation. Conclusions: Peripheral ulcerative keratitis is a potentially catastrophic ocular manifestation of rheumatoid arthritis requiring timely, intensive systemic and topical treatment by an ophthalmologist and a rheumatologist.

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