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Peripheral Ulcerative Keratitis in Sarcoidosis: A Case Report

Siracuse-Lee, Donna MD*; Saffra, Norman MD

doi: 10.1097/01.ico.0000183486.93259.c9
Case Reports
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Purpose: To document a case of peripheral ulcerative keratitis (PUK) that progressed to corneal perforation in the setting of recently diagnosed sarcoidosis.

Design: Observational case report.

Methods: A 42-year-old white woman presented with a 2-day history of tearing and decreased vision OD, secondary to PUK with corneal perforation. Slit-lamp evaluation revealed bilateral peripheral corneal thinning with vascularized scarring. History, clinical examination, chart review, peripheral lamellar keratoplasty, serologies, and bronchoscopy with biopsy were performed.

Results: After lamellar keratoplasty, visual acuity was 20/400 OD and 20/20 OS. She was treated with oral prednisone and high-dose Cytoxan therapy. One year postperforation, she received a limbus-to-limbus penetrating keratoplasty OD. One year after penetrating keratoplasty, the patient's BCVA OD is 20/40. She has stable scarring OS. Workup has revealed serologic and pathologic evidence of sarcoidosis without evidence of any other seropositive vasculitic disease.

Conclusion: This patient represents the first known case report of PUK in sarcoidosis. Oral Cytoxan, steroids, and topical cyclosporine have stabilized the disease process in this patient.

From the *Maimonides (Director of Cornea), Medical Center, Brooklyn, NY; Victory Memorial Hospital, Brooklyn, NY; and †Maimonides (Chairman of Opthalmology), Medical Center, Brooklyn, NY; New York Eye and Ear Infirmary, New York, NY; Mount Sinai Hospital, New York, NY; St. John's Hospital, Elmhurst, NY; Victory Memorial Hospital, Brooklyn, NY.

Received for publication November 23, 2004; revision received May 18, 2005; accepted July 11, 2005.

Reprints: Donna Siracuse-Lee, MD, 902 49th Street, Brooklyn, NY 11215 (e-mail: desiracuse@hotmail.com).

© 2006 Lippincott Williams & Wilkins, Inc.