Peripheral ulcerative keratitis – a severe complication of rheumatoid arthritis

Authors: N. Járová 1;  M. Palos 2;  Z. Mazal 1
Authors‘ workplace: Oční oddělení, Oblastní nemocnice Mladá Boleslav, a. s. 1;  Oční klinika Všeobecné fakultní nemocnice 1. LF UK, Praha 2
Published in: Čes. Revmatol., 22, 2014, No. 2, p. 100-106.
Category: Review Article


Rheumatoid arthritis is a systemic inflammatory disease of connective tissue. It can sometimes present itself with extraarticular symptoms, such as eye disorders. Although the most common manifestation is the dry eye disease, there are other severe conditions such as peripheral ulcerative keratitis as well. It is a destructive inflammation at the margin of corneal stroma associated with epithelial defect and progressive stromal degradation and thinning. This potentially devastating disorder can quickly produce necrosis of the corneal stroma, leading to perforation and blindness. In some cases, the peripheral ulcerative keratitis can be the first manifestation of underlying systemic disease. It can also indicate the presence of potentially lethal systemic vasculitis. Therefore, an early diagnose and adequate treatment protocol is key for achievement of satisfactory therapy results. A close cooperation between an ophthalmology and rheumatology specialist is necessary for successful treatment. The role of the rheumatologist is to medically manage patient´s systemic disease with regard to the dynamics of eye impairment. The ophthalmologist´s concern is mainly dealing with local complications and providing feedback for treatment modification. Only effective interdisciplinary cooperation can induce healing process and bring satisfactory treatment results.

Key words:
Rheumatoid arthritis, extraarticular symptoms, peripheral ulcerative keratitis, treatment


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Dermatology & STDs Paediatric rheumatology Rheumatology
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