Acute Bilateral Sterile Paracentral Corneal Perforation in a Steroid-Resistant Rheumatoid Arthritis Patient Treated with Penetrating Keratoplasty

Tao T and Sha X*

Department of Ophthalmology, The Second Affiliated Hospital of Guangzhou Medical University, China

^*Correspondance to: Xiangyin Sha 

 PDF  Full Text Case Report | Open Access

Abstract:

Objective: To present a case of central ulcerative keratitis that progressed from unilateral corneal perforation to bilateral perforation. Methods: A retrospective case report was conducted. Result: A 37-year-old female with Rheumatoid Arthritis (RA) presented with a one-month history of blurred vision in both eyes. After receiving inpatient care for paracentral corneal perforation and two corneal ulcers in her left eye, she was diagnosed with severe dry eyes. During the course of treatment involving systemic steroids and topical artificial tears, spontaneous perforation of interpalpebral ulcers occurred in her left eye. Three months after undergoing penetrating keratoplasty on both eyes, a corneal ulcer was observed in the right eye. Following treatment with immunosuppressants, topical autologous serum drops, and preservative-free artificial tears, significant recovery was noted along with improved vision. Conclusion: Long-lasting RA may result in ulcerative keratitis, which can be a significant contributor to corneal perforation. Therefore, it is crucial to conduct regular and thorough ocular examinations for RA patients before the onset of blurred vision.

Keywords:

Rheumatoid arthritis; Paracentral Corneal Perforation; Blurred vision; Penetrating Keratoplasty; immunosuppressants

Cite the Article:

Tao T, Sha X. Acute Bilateral Sterile Paracentral Corneal Perforation in a Steroid-Resistant Rheumatoid Arthritis Patient Treated with Penetrating Keratoplasty. Ann Clin Case Rep. 2023; 8: 2494..