BILATERAL MOOREN'S ULCER IN A HIV POSITIVE PATIENT - CASE REPORT
Published 2023 - 27th ESCRS Winter Meeting
Reference: P108 | Type: Presented Poster & Poster Submission | DOI: 10.82333/qxjn-as32
Authors: Eddaoui Hibat Allah* 1 , anis regragui 1 , benharbit mohammed 1 , Nabiha benchekroun 1 , Mohammed Belmekki 1
1Cheikh Zaid international hospital,Rabat,Morocco
Purpose
Mooren's ulcer is a chronic, painful ulcerative keratitis affecting initially the peripheral cornea with a a centripetal progression and whose etiology and pathophysiology remain unknown.
We report an observation with bilateral involvement in a HIV positive patient.
Setting
We report the case of a 46-year-old female patient from West Africa, HIV-positive and undergoing antiretroviral treatment, who presented a bilateral Mooren's ulcer. Her first ophthalmological examination revealed an opaque cornea with a 360° peripheral ulcer perforated in several places and herniation of the iris in the right eye. In the left eye, the examination showed a Mooren's ulcer over 240° from 5h to 1h with a micro perforation in the lower part.The clinical investigation of other causes of the ulcer returned negative
Local corticosteroid therapy (dexamethasone) was instituted and an amniotic membrane graft was performed on both eyes.
Successive ophthalmological examinations showed a clear improvement of the inflammatory state with corneal healing. However, she retained a total opacification of the cornea in the right eye .
Methods
Quantitative retrospective monocentric study conducted at the Sheikh Zayd University Hospital in Rabat in October 2022
Results
UM is a rare pathology of which different clinical forms have been described. The diagnosis of Mooren's ulcer is a diagnosis of elimination. In our case, the diagnosis of Mooren's ulcer was made after eliminating pseudo-UM related to local causes (viral infections, trauma, systemic diseases, tuberculosis, helminthiasis...). All these pathologies can potentially mimic the picture of a UM and therefore speak of a pseudo-Mooren.
Its pathophysiology remains poorly understood. Recent studies have shown high serum levels of autoantibodies directed against a corneal storma antigen. The relationship of UM and HIV has not been clearly established. The reconstitution syndrome described after initiation of triple therapy could be associated with Mooren's ulcer and eventually explain the case of our patient
Conclusion
Mooren's ulcer could be among the ophthalmologic manifestations to be evoked during HIV . Further works are needed to elucidate the relationship between these two entities.