Abstract
AIMS—To estimate the incidence of corneal melting or necrotising keratitis in association with systemic disease in the Yorkshire Region and to determine the type and duration of the systemic association. METHODS—In a prospective study, vigorous attempts were made to identify all patients presenting with newly diagnosed corneal melting over a 3 year period. RESULTS—27 patients were identified during the study period. Rheumatoid arthritis and Wegener's granulomatosis were the most common disease associations. Corneal melting was a late complication of rheumatoid arthritis, but usually occurred during early and overt systemic disease in patients with Wegener's granulomatosis. CONCLUSION—The annual incidence of corneal melting in the Yorkshire Region is 3.01/million/year (95% CI = 0.7-9.6).
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- Bacons P. A., Kitas G. D. The significance of vascular inflammation in rheumatoid arthritis. Ann Rheum Dis. 1994 Oct;53(10):621–623. doi: 10.1136/ard.53.10.621. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bernauer W., Ficker L. A., Watson P. G., Dart J. K. The management of corneal perforations associated with rheumatoid arthritis. An analysis of 32 eyes. Ophthalmology. 1995 Sep;102(9):1325–1337. doi: 10.1016/s0161-6420(95)30867-6. [DOI] [PubMed] [Google Scholar]
- Bullen C. L., Liesegang T. J., McDonald T. J., DeRemee R. A. Ocular complications of Wegener's granulomatosis. Ophthalmology. 1983 Mar;90(3):279–290. doi: 10.1016/s0161-6420(83)34574-7. [DOI] [PubMed] [Google Scholar]
- Emery P., Salmon M. Early rheumatoid arthritis: time to aim for remission? Ann Rheum Dis. 1995 Dec;54(12):944–947. doi: 10.1136/ard.54.12.944. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hoffman G. S., Leavitt R. Y., Fleisher T. A., Minor J. R., Fauci A. S. Treatment of Wegener's granulomatosis with intermittent high-dose intravenous cyclophosphamide. Am J Med. 1990 Oct;89(4):403–410. doi: 10.1016/0002-9343(90)90367-m. [DOI] [PubMed] [Google Scholar]
- Kervick G. N., Pflugfelder S. C., Haimovici R., Brown H., Tozman E., Yee R. Paracentral rheumatoid corneal ulceration. Clinical features and cyclosporine therapy. Ophthalmology. 1992 Jan;99(1):80–88. doi: 10.1016/s0161-6420(92)32006-8. [DOI] [PubMed] [Google Scholar]
- Messmer E. M., Foster C. S. Destructive corneal and scleral disease associated with rheumatoid arthritis. Medical and surgical management. Cornea. 1995 Jul;14(4):408–417. doi: 10.1097/00003226-199507000-00010. [DOI] [PubMed] [Google Scholar]
- Pfister R. R., Murphy G. E. Corneal ulceration and perforation associated with Sjögren's syndrome. Arch Ophthalmol. 1980 Jan;98(1):89–94. doi: 10.1001/archopht.1980.01020030091006. [DOI] [PubMed] [Google Scholar]
- Scott D. G., Bacon P. A., Tribe C. R. Systemic rheumatoid vasculitis: a clinical and laboratory study of 50 cases. Medicine (Baltimore) 1981 Jul;60(4):288–297. [PubMed] [Google Scholar]
- Tauber J., Sainz de la Maza M., Hoang-Xuan T., Foster C. S. An analysis of therapeutic decision making regarding immunosuppressive chemotherapy for peripheral ulcerative keratitis. Cornea. 1990 Jan;9(1):66–73. [PubMed] [Google Scholar]
- Watson P. G. Vascular changes in peripheral corneal destructive disease. Eye (Lond) 1990;4(Pt 1):65–73. doi: 10.1038/eye.1990.7. [DOI] [PubMed] [Google Scholar]
- Watts R. A., Carruthers D. M., Scott D. G. Epidemiology of systemic vasculitis: changing incidence or definition? Semin Arthritis Rheum. 1995 Aug;25(1):28–34. doi: 10.1016/s0049-0172(95)80015-8. [DOI] [PubMed] [Google Scholar]
- Watts R. A., Carruthers D. M., Symmons D. P., Scott D. G. The incidence of rheumatoid vasculitis in the Norwich Health Authority. Br J Rheumatol. 1994 Sep;33(9):832–833. doi: 10.1093/rheumatology/33.9.832. [DOI] [PubMed] [Google Scholar]