Results of chemotherapy immunosuppressors in peripheral ulcerative keratitis associated to systemic immune diseases Resultados de la quimioterapia inmunosupresora en la queratitis ulcerativa periférica asociada a enfermedades sistémicas inmunes
Purpose: Analyze and provide recommendations on the management of peripheric ulcerative keratitis with systemic immunosuppressors in patients with immune diseases. Methods: Retrospective non comparative case series of 19 patients (29 eyes) with peripheral ulcerative keratitis managed with immunosuppressive drugs according to the associated immune systemic disease. Therapeutic response, follow-up time, recurrences, ocular complications and adverse effects were analyzed. Results: The mean age at presentation was 53.05 ± 16.29 years; with an M:F ratio of 1:5.3. The most common associated systemic disease was rheumatoid arthritis (84%). The median follow-up time was 10 months. The mean time of response to immunosuppressive therapy was 8.06 ± 5.63 weeks, with recurrences occurring in 31% of the patients during followup. Ocular complications occurred in 13.7% of the eyes. Adverse effects presented in 36.8% of patients, of these, 85.7% responded to reduction of the immunosuppressive dose. Conclusions: The use of immunosuppressive therapy in patients with peripheric ulcerative keratitis associated with systemic immune disease provides control of the life-threatening systemic vasculitis and prevents the progression of the inflammatory process. The correct, opportune use of immunosuppresors achieves these objectives in the majority of cases. Failure in implementing an adequate therapy leads to a significant morbid-mortality risk and ocular tissue destruction.