The Clinical Manifestations and Prognostic Factors of Autoimmune-Related Peripheral Corneal Ulcers

Purpose: To investigate clinical manifestations and prognostic factors of autoimmune-related peripheral corneal ulcers. Methods: Nineteen eyes in 18 patients who were diagnosed with autoimmune-related peripheral corneal ulcer from November 1999 to August 2010 were enrolled in the present study. Clinical manifestations and treatment results were investigated retrospectively. Results: The average age at presentation was 64.6 years with female (66.7%) and unilateral (94.4%) dominance. The main etiologies were Mooren’s ulcer (53.6%) and rheumatoid arthritis (26.3%). The ulcer depth was greater than 75% of the corneal thickness in more than half of the cases (57.9%) and the mean extent of the ulcer was 69.5°. There were no significant improvements in visual acuity after treatment ( p = 0.789) and no significant differences in treatment outcomes among etiologies or treatment modalities. The patients who underwent ulcer recurrence ( p = 0.048) or treatment failure ( p = 0.005) had poorer final visual acuity than those patients who did not. The ulcer depth correlated with treatment failure ( p = 0.037). The final visual acuity showed positive correlations with visual acuity at presentation ( p = 0.031) and negative correlations with the number of recurrences ( p = 0.042). Conclusions: The visual acuity at presentation and ulcer depths were significant prognostic factors. These factors appeared to be helpful in the treatment of marginal keratitis depending on the depth of the ulcer.