Siracuse-Lee Donna, Saffra Norman
Maimonides Medical Center, Brooklyn, NY, USA.
Cornea. 2006 Jun;25(5):618-20. doi: 10.1097/01.ico.0000183486.93259.c9.
To document a case of peripheral ulcerative keratitis (PUK) that progressed to corneal perforation in the setting of recently diagnosed sarcoidosis.
Observational case report.
A 42-year-old white woman presented with a 2-day history of tearing and decreased vision OD, secondary to PUK with corneal perforation. Slit-lamp evaluation revealed bilateral peripheral corneal thinning with vascularized scarring. History, clinical examination, chart review, peripheral lamellar keratoplasty, serologies, and bronchoscopy with biopsy were performed.
After lamellar keratoplasty, visual acuity was 20/400 OD and 20/20 OS. She was treated with oral prednisone and high-dose Cytoxan therapy. One year postperforation, she received a limbus-to-limbus penetrating keratoplasty OD. One year after penetrating keratoplasty, the patient's BCVA OD is 20/40. She has stable scarring OS. Workup has revealed serologic and pathologic evidence of sarcoidosis without evidence of any other seropositive vasculitic disease.
This patient represents the first known case report of PUK in sarcoidosis. Oral Cytoxan, steroids, and topical cyclosporine have stabilized the disease process in this patient.
记录一例在近期诊断为结节病的情况下进展为角膜穿孔的周边溃疡性角膜炎（PUK）病例。
观察性病例报告。
一名42岁白人女性因PUK伴角膜穿孔出现流泪和右眼视力下降2天前来就诊。裂隙灯检查发现双侧周边角膜变薄伴血管化瘢痕形成。进行了病史采集、临床检查、病历回顾、周边板层角膜移植术、血清学检查以及支气管镜检查和活检。
板层角膜移植术后，右眼视力为20/400，左眼视力为20/20。她接受了口服泼尼松和大剂量环磷酰胺治疗。穿孔后一年，她接受了右眼全角膜缘穿透性角膜移植术。穿透性角膜移植术后一年，患者右眼最佳矫正视力为20/40。左眼瘢痕稳定。检查发现有结节病的血清学和病理学证据，无任何其他血清学阳性血管炎疾病的证据。
该患者是已知的首例结节病合并PUK病例报告。口服环磷酰胺、类固醇和局部用环孢素使该患者的病情得到了稳定。
