The Charles T. Campbell Eye Microbiology Lab
UPMCUniversity of Pittsburgh Schools of the Health Sciences
HomeContact InformationLab Diagnostic TestingAntibiotic SusceptibilityAntimicrobial TherapyCurrent ResearchPhotos

Ocular Microbiology and Immunology Group
Back to OMIG Main Page

< Previous | 2020 Agenda and Abstracts | Next >


2020 OMIG Abstract

Correlation between Active Central Corneal Ulceration with the Inflammatory Status of Systemic Autoimmune Disease

Luis Alberto Rodriguez Gutierrez, MD, J. Carlos Alvarez Guzman, MD, Andres Bustamante Arias, MD, Alejandro Rodriguez Garcia, MD
Department of Ophthalmology, Tecnologico de Monterrey, Monterrey, Mexico

Purpose: Considering that systemic autoimmune response may play a role in the pathogenic mechanism of central corneal ulceration in patients with Sjögren syndrome, we analyzed the correlation between corneal ulceration and disease activity, or its reactivation related to systemic drug reduction, discontinuation, or therapeutic failure.

Methods: A retrospective and longitudinal case series study of patients with primary (pSS) or secondary Sjögren syndrome (sSS) seen between January and October 2019 were conducted. Inclusion criteria comprised patients with a known diagnosis of pSS or sSS, according to the AECG-2016 consensus, who presented with active sterile ulceration in the central or paracentral cornea. An analysis of the signs and symptoms associated with systemic disease activity; the therapeutic status including drug failure, reduction, or discontinuation was performed, as well as levels of serologic biomarkers of inflammation like ESR, CRP, LDH, and autoantibodies determined at the time of ulceration.

Results: A total of 19 patients, 17 (89.4%) women, and 2 (10.6%) men with a mean age of 56.7 years were included for analysis. Five (26.3%) patients had a diagnosis of pSS and 14 (73.7%) of sSS. ESR was high in 81.3% of patients and CRP in 61.5% of them. Half of the patients had elevated LDH, individual markers of disease activity such as anti-citrullinated protein antibodies (ACPA’s) were elevated in 44.4% of patients, 28.6% of patients had leukopenia, leukocytosis was present in 7.14% of patients. All patients were considered undertreated at the time of ulcer appearance, requiring systemic therapy adjustment with resultant improvement.

Conclusion: A marked correlation was found between central corneal ulceration and increased systemic disease activity. There was a strong association between serologic biomarkers and undertreatment with disease activity. We consider that appropriate systemic treatment is required as part of the ocular surface management in these patients.

Disclosure: N



< Previous | 2020 Agenda and Abstracts | Next >