Peripheral Ulcerative Keratitis Revealed By Inflammatory Bowel Disease
Published 2024 - 42nd Congress of the ESCRS
Reference: PO114 | Type: Case Report | DOI: 10.82333/z8b5-4025
Authors: Delphes Mathilde Otsasso Okomiko* 1 , Zineb Hammoumi 1 , Cherif Lemine 1 , Neama Bouhazzama 1 , Zineb Morchid 1 , Sarah Houti 1 , salaheddine Dahrane 1 , Zyad Laftimi 1 , Ghizlane Daghouj 1 , Loubna El Maaloum 1 , Bouchra Allali 1 , Asmaa El Kettani 1
1Pediatric ophtalmology,Hôpital 20 Aout 1953,Casablanca,Morocco
Purpose
To describe a clinical case of peripheral ulcerative keratitis revealed by inflammatory bowel disease.
Setting
Peripheral ulcerative keratitis (PUK) is a marginal ulcer that is most often autoimmune. Their diagnosis must be made early because of the real risk of corneal perforation. They can be the first manifestation of a serious systemic disease that was previously unknown to the patient.
Report of case
This is a woman, 24 years old, whose history of the disease dates back 2 years after her delivery by the onset of bloody diarrhea associated with arthralgia, mucocutaneous involvement such as purulent nodule of the scalp and genital ulceration, ocular involvement with blurring and left eye pain, deterioration in general condition with weight loss and asthenia.
Examination of the digestive tract reveals tenderness of the right iliac fossa and right flank with the presence of a hemorrhoidal marisk
Joint examination reveals a stiff spine, pain and limited mobility and deforming arthritis of the hands.
Ophthalmological examination revealed visual acuity of 6/10th of the right eye, infiltrates of the temporal limbus, and of the left eye, visual acuity of 2/10th, perforation within the descmetocele, ectasia of the iris with an anterior chamber diminished in depth.
In the gastrology department, a rectosigmoidoscopy revealed an exulcerated rectosigmoiditis suggestive of an inflammatory bowel disease type of Crohn's disease, on colonoscopy an ulceration of the rectum and sigmoid with a healthy mucosal interval reminiscent of a Crohn's disease, and the biopsy confirmed a chronic colitis in acute ulcerated flare-up consistent with inflammatory bowel disease.
The course of action to be taken consisted of hospitalization of the patient and the administration of medical treatment based on corticosteroid, antibiotics and immunosuppressants as well as the placement of an amniotic membrane.
Conclusion/Take home message
In the presence of any systemic pathology, make an ophthalmological examination systematically, especially if there are signs of calling. During collagenosis or systemic vasculitis, the occurrence of an inflammatory peripheral corneal ulcer is associated with an increased risk of life.