What is the role of immunosuppressive drugs in the treatment of peripheral ulcerative keratitis (PUK)?

Updated: Jun 11, 2019
  • Author: Ellen N Yu-Keh, MD; Chief Editor: Andrew A Dahl, MD, FACS  more...
  • Print
Answer

Many studies have documented that patients with PUK who have associated systemic diseases have recurrences following localized temporizing treatment unless they are given adequate systemic immunosuppressive therapy. To address the underlying problem, both systemic steroid and cytotoxic immunosuppressive medications have been used, alone or in combination, and are effective at controlling ocular and systemic inflammation. Immunosuppressive agents have been indicated for management of the following:

  • PUK associated with potentially lethal systemic vasculitic syndromes, such as PAN, RA, SLE, RP, GPA, PSS, Sjögren syndrome, allergic angiitis of Churg-Strauss, and giant cell arteritis
  • PUK associated with necrotizing scleritis with vasculitis based on histopathologic analysis
  • Bilateral and/or progressive Mooren ulcer
  • PUK unresponsive to aggressive conventional medical and surgical therapy

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!