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Peripheral ulcerative keratitis: retrospective review of 19 eyes from Tunisia

Poster Details

First Author: N.Abroug TUNISIA

Co Author(s):    S. Khochtali   R. Kahloun   I. Ksiaa   B. Jelliti   S. Zaouali   M. Khairallah

Abstract Details


To assess demographic data, clinical features, and diseases associated with peripheral ulcerative keratitis (PUK).


From January 2002 to September 2012; Department of Ophthalmology, Fattouma Bourguiba University Hospital, Monastir, Tunisia


Retrospective review of 15 patients (19 eyes) diagnosed with PUK. All patients underwent detailed ophthalmic examination and guided investigations including systemic investigation by internist and rheumatologist.


Patients had a mean age of 48.5 years (30-59) and were male in 73.3% of cases. Four patients had bilateral involvement. A keratoconjunctivitis sicca and scleritis were associated in 47.4% and 26.3% of cases, respectively. Rheumatoid arthritis was the main etiology (10 patients; 66.7%). Others associated diseases included systemic lupus erythematosus (N=1), Wegener granulomatosis (N=1), and Mooren ulcer (N=1). All patients were treated with topical corticosteroids and 11 patients (73.3%) received oral corticosteroids. Two patients were treated with azathioprine for refractory ulcers. Final visual acuity was ≥5/10 in 73.7% of eyes. Corneal perforation was seen in 15.8% of eyes.


Peripheral ulcerative keratitis is a sight-threatening condition commonly associated with systemic immune disease. The main cause is rheumatoid arthritis. Corticosteroid is an effective treatment, with good anatomical and functional prognosis in the majority of patients. Immunosuppressive therapy is useful in controlling severe PUK, as well as underlying systemic disease.

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