Herpes Simplex Keratitis in Rheumatoid Arthritis Patients.

Authors :: Larrañaga Fragoso P
Boto de Los Bueis A
Bravo Ljubetic L
Del Hierro Zarzuelo A
Romero Gómez MP
Mora Rillo M
Source :: Ocular immunology and inflammation [Ocul Immunol Inflamm] 2016 Jun; Vol. 24 (3), pp. 282-7. Date of Electronic Publication: 2014 Aug 20.
Publication Year :: 2016
Abstract: Purpose: To describe a series of 5 patients with herpes simplex virus keratitis (HSK) and rheumatoid arthritis (RA) under immunosuppressive treatment.<br />Methods: Retrospective study. Detailed data were obtained regarding symptoms and signs at the initial evaluation, treatment, microbiological diagnostic tests, evolution, and outcomes.<br />Results: Five patients with HSK and RA were identified. Bilateral involvement occurred in 2 patients (40%). Epithelial keratitis was diagnosed in 5 eyes. Three eyes showed severe melting with eye perforation. Gram-positive bacterial co-infections were common in the group with stromal keratitis. We did not find differences in the evolution of the disease based on anti-rheumatoid treatment.<br />Conclusions: The characteristics of HSK in patients with RA differed from HSK in immunocompetent patients. The stromal keratitis cases were very aggressive and difficult to manage, with perforation and gram-positive bacterial co-infection as frequently associated conditions. Prophylactic therapy at standard doses was unsuccessful to avoid recurrences.