Immune-associated peripheral ulcerative keratitis:feasibility of systemic immunomodulation combined with surgical treatment
- VernacularTitle:免疫性周边溃疡性角膜炎:系统免疫调节联合手术治疗的可行性
- Author:
Xiaohan LIU
1
;
Yingxin CHEN
;
Minghong GAO
Author Information
- Publication Type:Journal Article
- Keywords: peripheral ulcerative keratitis; pathogenesis; systemic autoimmune diseases; limbus; immunomodulatory therapy; keratoplasty; lamellar keratoplasty; acellular porcine corneal stroma; engineered tissue construction
- From: Chinese Journal of Tissue Engineering Research 2025;29(26):5713-5720
- CountryChina
- Language:Chinese
- Abstract: BACKGROUND:If not detected and treated in a timely manner,immune-associated peripheral ulcerative keratitis can lead to corneal thinning,ulcers and even perforation,thereby causing visual loss and affecting the patient's quality of life.OBJECTIVE:To discuss the pathogenesis of immune-associated peripheral ulcerative keratitis and summarize the diagnosis and treatment ideas and the latest treatment methods for this disease.METHODS:Search terms were"peripheral ulcerative keratitis,immunity,immune system disease,pathogenesis,immunomodulatory therapy,surgical treatment,keratoplasty"in English and Chinese.Relevant literature on peripheral ulcerative keratitis published from database inception to October 2024 was searched by computer in CNKI,WanFang,PubMed,and El databases.A total of 68 papers were ultimately selected to comprehensively describe the new research progress in the research on immune-associated peripheral ulcerative keratitis.RESULTS AND CONCLUSION:Immune-associated peripheral ulcerative keratitis includes Mooren's ulcer,blepharokeratoconjunctivitis,superior limbic keratoconjunctivitis,and autoimmune related peripheral ulcerative keratitis.Due to the physiology of the corneal limbus,peripheral ulcerative keratitis is usually associated with an immune response,and the pathophysiologic mechanism is usually related to the deposition of immune complexes in the blood vessels at the limbus and the production of microangiitis.Systemic immunomodulatory therapy should be used whether or not an autoimmune disease is diagnosed prior to the onset of immune-associated peripheral ulcerative keratitis,which can help to reduce ocular complications associated with systemic inflammation.Nonsurgical treatment,such as immunomodulatory therapy,is beneficial for relieving ocular symptoms,but when nonsurgical treatment is ineffective or the lesion infiltrates the Descemet membrane,it can cause corneal perforation.Combined surgical treatment can help maintain the structural integrity of the eyeball.However,there is no clear evidence for the combination of immunomodulatory therapy and surgical treatment in the development of immune-associated Peripheral ulcerative keratitis.This article reviews the literature on the diagnosis and treatment of immune-associated peripheral ulcerative keratitiss.
