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A. F. Saati, A. A. Al-Rajhi, K. F. Tabbara; Long-Term Outcome of Mooren's Ulcer. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4298.
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The purpose of this study was to evaluate the clinical manifestations and long-term outcome of Mooren’s ulcer and to assess the associated risk factors.
The medical records of 44 patients with Mooren’s ulcer were reviewed. The diagnosis was based on the clinical manifestations and absence of systemic diseases. Patients who had a follow-up period of less than 6 months were excluded. Data included history, ophthalmic findings, natural course of the disease, complications and outcome after topical, systemic medications, and surgical treatment.
There were a total of 70 eyes among 44 patients (37 males and 7 females). The age range was 14-98 years with a mean age of 65.5 years. The incidence of Mooren’s ulcer in the outpatient clinic was 4.4 in 10,000.There were 26 cases with bilateral disease and 18 cases with unilateral disease. None of the 19 patients who were tested for Hepatitis C antibodies were positive. Two out of 12 patients that had stool analysis had parasitic infestations. Management included: perilimbal conjunctival resection, customized corneal graft, epikeratoplasty, amniotic membrane transplantation, systemic steroids, cyclosporine, azathioprine or cyclophosphamide. Sixty one (87%) eyes healed with corneal vascularization and scarring after a mean follow up period of 38 months (range 6-204 months). Nineteen (27%) eyes had corneal perforation while on treatment. Thirty three (47%) eyes had a final visual acuity of 20/200 or worse, 33 (47%) eyes were better than 20/200 and 4 (4.5%) eyes had no light perception (3 were eviscerated).Thirty seven eyes received immunosuppressive therapy, 15 (40.5%) eyes had a visual acuity of 20/200 or worse, 21 (56%) eyes had a better than 20/200 visual acuity, and 1 (2.7%) eye had no light perception. There was no statistically significant difference in the disease severity and outcome between patients who had a bilateral disease or unilateral disease (p = 0.7).
The outcome of Mooren’s ulcer was poor despite immunosuppressive and surgical treatment. New approaches for treatment are highly desirable.
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