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  • Peripheral ulcerative keratitis in rheumatoid arthritis: successful use of intravenous cyclophosphamide and comparison of clinical and serological characteristics

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Peripheral ulcerative keratitis in rheumatoid arthritis: successful use of intravenous cyclophosphamide and comparison of clinical and serological characteristics
  1. A R Clewes1,
  2. J K Dawson2,
  3. S Kaye3,
  4. R C Bucknall1
  1. 1Rheumatic Diseases Unit, Royal Liverpool University Hospital, Liverpool, UK
  2. 2Department of Rheumatology, St Helens and Knowsley Hospitals NHS Trust, St Helens, Merseyside, UK
  3. 3Department of Ophthalmology, St Paul’s Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
  1. Correspondence to:
    Dr A R Clewes
    Rheumatic Diseases Unit, Link 7c, Royal Liverpool University Hospital, Prescot Street, Liverpool, L7 8XP, UK; adrianaclewes.freeserve.co.uk

https://doi.org/10.1136/ard.2004.023283

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    Peripheral ulcerative keratitis (PUK) is a devastating complication of rheumatoid arthritis (RA) that can lead to rapid corneal destruction (corneal melt) and perforation with loss of vision (fig 1). It is well reported to herald systemic vasculitis and carries a high mortality rate if not aggressively treated.1 There is a paucity of information concerning the clinical and serological characteristics of these patients and no clear consensus about treatment.

    Figure 1

     Note the peripheral circumferential damage from corneal ulceration (arrows).

    We report the successful management of seven such patients with the use of intravenous cyclophosphamide and compare the serological and clinical characteristics with a comparative group of 150 rheumatoid patients without associated PUK, who attended an outpatient clinic.

    CASE REPORTS

    All patients received systemic immunosuppressive treatment with intravenous cyclophosphamide and the …

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