Abstract
Purpose: :
To determinate the efficacy of autologous serum drops (ASD) as an adjuvant in the treatment of patients with peripheral ulcerative keratitis (PUK).
Methods: :
We included patients with autoimmune PUK. All patients were treated with systemic immunosuppressors and showed no improvement. All patients received treatment with ASD at 50% quid. Minimum follow–up time was 3 months. Demographic variables, associated systemic disease, eye examination and response to the treatment were evaluated.
Results: :
Three women and two men were included. Average age was 41 ± 6.3 years. Wegener’s granulomatosis (WG) was diagnosed in two patients, rheumatoid arthritis (RA) in two and one was diagnosed with Stevens – Johnson syndrome (SJS). All the patients had systemic immunosuppression therapy with prednisone (1 mg/Kg/day). The patients with WG had additional therapy with cyclofosfamide (100 mg/day) and the patients with AR received metotrexate (10 – 12.5 mg/week). Mean time of ASD treatment was 3.2 ± 0.9 months. A conjunctival overgrowth covering the ulcerated area was observed, in 6 weeks in three patients; two of them had AR and the other one had WG. A corneal re–epithelization was observed in the patient with SJS in 8 weeks. Only one patient with WG developed a corneal perforation underneath the conjunctival overgrowth at week 8.
Conclusions: :
ASD may be an adjuvant in the treatment of PUK. It seems to promote ulcer healing stimulating, and in some cases, a conjunctival overgrowth. ASD may be helpful in autoimmune PUK cases unresponsive to systemic immunosuppressive therapy.
Keywords: cornea: clinical science • inflammation • wound healing