蕭裕泉醫師眼科筆記

Corneal diagnoses and systemic disease Mooren's ulcer vs. PUK: The difference can mean life or death by Enette Ngoei EyeWorld Contributing Editor An example of Mooren's ulcer PUK with scleritis in a patient with RA Source (all): Virender S. Sangwan, M.D. Telling the difference between Mooren's ulcer and early signs of something deadly While Mooren's ulcer is by definition not associated with any systemic autoimmune disorder, it can be confused with corneal ulcers that are early warning signs of life-threatening diseases, said C. Stephen Foster, M.D., founder and president, Massachusetts Eye Research and Surgery Institute, Cambridge, and clinical professor of ophthalmology, Harvard Medical School, Boston. Therefore, the general ophthalmologist ought to hear alarm bells ring if the peripheral corneal disease has the following characteristics: It is a real ulcer, that is, the epithelium is not intact, there is some loss of stroma, it is a rea...

Corneal diagnoses and systemic disease PUK and systemic autoimmune disease by Michelle Dalton EyeWorld Contributing Editor   PUK is clearly identifiable in this patient Source: Sophie X. Deng, M.D. An example of marginal (limbal) herpes simplex keratitis (mimicking PUK) Source: Vincent P. de Luise, M.D. Mooren's ulcer caused this patient's PUK Source: Vincent P. de Luise, M.D. Usually considered an ocular manifestation of a systemic autoimmune disorder, peripheral ulcerative keratitis can result in devastating outcomes—including permanent loss of vision Peripheral ulcerative keratitis (PUK) is typically associated with poorly managed systemic conditions such as rheumatoid arthritis (RA accounts for almost one-third of non-infectious PUK), among others. What can cause it? "VAST CRIMES," said Vincent P. de Luise, M.D., assistant clinical professor of ophthalmology, Yale University School of Medicine, New Haven, Conn. PUK can be caused by ...