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Bilateral peripheral ulcerative keratitis following treatment with rituximab

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Session Details

Session Title: Presented Poster Session: Cornea II

Venue: Poster Village: Pod 2

First Author: : S.Stanojlovic SERBIA

Co Author(s): :    V. Milic   S. Zivojinovic   T. Kalezic        

Abstract Details

Purpose:

To report the clinical course and medical treatment of peripheral ulcerative keratitis (PUK) occurring in both eyes subsequently, following treatment with rituximab, in a patient with sero-positive rheumatoid arthritis (RA).

Setting:

University Eye Hospital, Institute of Rheumatology, Belgrade, Serbia

Methods:

Observational case report.

Results:

A 64-year-old woman with seropositive RA developed bilateral PUK. Acute exacerbation of ocular inflammation occurred during maintenance treatment with methotrexate and 2 months following induction treatment with rituximab. Slit-lamp examination revealed severe superior corneal thinning in the left eye. The patient was initially treated with high-dose prednisolone. Within 8 weeks, a total epithelization of the ulcer was achieved. Six months later, progressive PUK developed in her right eye. She was immediately treated with a course of cyclophosphamide. Although the inflammation was arrested in both eyes, the advanced PUK led to reduced visual acuity due to corneal tinning and irregular astigmatisms.

Conclusions:

Introduction of high-dose pulsed cyclophosphamide arrested bilateral PUK which developed following rituximab treatment of severe RA.

Financial Disclosure:

NONE

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