Sura Amol A, McCallum Rex M
Department of Ophthalmology.
Department of Medicine, Division of Rheumatology, Duke University, Durham, North Carolina, USA.
Curr Opin Ophthalmol. 2022 Nov 1;33(6):543-550. doi: 10.1097/ICU.0000000000000895. Epub 2022 Sep 19.
To discuss peripheral ulcerative keratitis, with a focus on the evaluation and management of associated systemic diseases.
Peripheral ulcerative keratitis (PUK) is a sight-threatening condition that is often defined by the presence of a crescent-shaped area of peripheral corneal thinning, an epithelial defect, and an inflammatory corneal infiltrate. It is highly associated with rheumatoid arthritis, systemic necrotizing vasculitides like granulomatosis with polyangiitis, and collagen vascular diseases like systemic lupus erythematosus. Undertreated PUK carries a risk of vision loss and premature death.
Multidisciplinary collaboration between the ophthalmologist, rheumatologist, and other consultants is required. Early and aggressive steroid-sparing therapy should be considered in cases due to noninfectious systemic disease.
讨论周边溃疡性角膜炎，重点关注相关全身性疾病的评估与管理。
周边溃疡性角膜炎（PUK）是一种威胁视力的疾病，通常表现为周边角膜变薄的新月形区域、上皮缺损和角膜炎性浸润。它与类风湿性关节炎、系统性坏死性血管炎（如肉芽肿性多血管炎）以及胶原血管疾病（如系统性红斑狼疮）高度相关。未经治疗的PUK有视力丧失和过早死亡的风险。
眼科医生、风湿病学家和其他会诊医生之间需要多学科协作。对于由非感染性全身性疾病引起的病例，应考虑早期积极的类固醇节省疗法。
