Huerva Valentín, Ascaso Francisco J, Grzybowski Andrzej
From the Department of Ophthalmology (VH), University Hospital Arnau de Vilanova; IRB Lleida (VH), Lleida; Department of Ophthalmology, "Lozano Blesa" University Clinic Hospital (FJA); Instituto Aragonés de Ciencias de la Salud (FJA), Zaragoza, Spain; and Department of Ophthalmology (AG), Poznań City Hospital, Poznań, Poland.
Medicine (Baltimore). 2014 Nov;93(26):e176. doi: 10.1097/MD.0000000000000176.
Biologic agents such as anti-TNFα have been employed in treatment paradigms for ocular inflammation. Peripheral corneal ulceration (PUK) is a devastating disorder consisting of a crescent-shaped area of destructive inflammation at the margin of the corneal stroma. It is associated with an epithelial defect, the presence of stromal inflammatory cells, and progressive stromal degradation and thinning, leading to ocular perforation and devastating visual loss. Macroulcerative PUK is usually a local manifestation of a systemic vasculitis. In many cases, the disease may be resistant to high doses of systemic corticosteroids and immunosuppressants. Chimeric anti-TNFα has been employed when all other treatments have failed. Isolated cases and short series of cases have been reported. This paper summarizes the available reports on the use, efficacy, and safety of infliximab in the treatment of PUK.
生物制剂如抗TNFα已被应用于眼部炎症的治疗方案中。周边角膜溃疡（PUK）是一种破坏性疾病，表现为角膜基质边缘新月形的破坏性炎症区域。它与上皮缺损、基质炎性细胞的存在以及基质的进行性降解和变薄有关，可导致眼球穿孔和严重的视力丧失。巨大溃疡性PUK通常是系统性血管炎的局部表现。在许多情况下，该疾病可能对高剂量的全身性皮质类固醇和免疫抑制剂耐药。当所有其他治疗均失败时，已使用嵌合抗TNFα。已有孤立病例和短系列病例报道。本文总结了关于英夫利昔单抗治疗PUK的使用、疗效和安全性的现有报告。
