A recent study published in the American Journal of Ophthalmology observed clinical outcomes in patients with peripheral ulcerative keratitis (PUK).
Peripheral Ulcerative Keratitis
PUK is an inflammatory disease characterized by peripheral corneal thinning. It is commonly associated with autoimmune diseases such as rheumatoid arthritis, polyarteritis nodosa, inflammatory bowel disease, collagen vascular diseases, and ANCA vasculitides. The condition occurs when immune complexes activate the complement system resulting in chemotaxis of inflammatory cells that destroy corneal stroma. Common symptoms include pain, redness, tearing, photophobia, and decreased vision.
Study
The purpose of this study was to evaluate the clinical and treatment outcomes in patients with PUK. Data was collected on the demographics, presence of systemic disease, disease laterality, duration of disease, PUK activity, presence of corneal perforation, and treatments. In total, 57 patients were identified and analyzed, with 81 eyes affected by the disease.
Results
The median age of participants was 53 years. 46% of patients were Black and 56% of patients had an associated systemic diagnosis. The median duration of symptoms prior to presentation was three months and 42% presented with bilateral disease. Seven of the affected eyes had perforated prior to presentation.
During a median follow-up of three years, 76% received oral prednisone and 80% received at least one immunosuppressive drug. Disease control was achieved in all patients within a median of 1.3 months. The rate of corticosteroid-sparing success was 0.44 per patient-year and the rate of corticosteroid discontinuation was 0.27 per patient-year. Sustained drug-free remission was achieved in 6% of patients.
Overall, it was observed that with moderate follow-up, systemic therapy achieved disease control, corticosteroid-sparing, and corticosteroid discontinuation. However, sustained drug-free remission appeared to be infrequent.
For more information, click here.
To learn more about rare ophthalmological conditions, visit https://checkrare.com/diseases/ophthalmology-eye-diseases/
References:
Mallem K, et al. Clinical Outcomes in Peripheral Ulcerative Keratitis. 2025. American Journal of Ophthalmology. https://www.ajo.com/article/S0002-9394(25)00030-3/abstract
Stenz JM, et al. Peripheral Ulcerative Keratitis. 2024. American Academy of Ophthalmology EyeWiki. https://eyewiki.org/Peripheral_Ulcerative_Keratitis
