Reiter's Keratitis

Mark, David B.; McCulley, James B.

doi:10.1001/archopht.1982.01030030785011

Cited by 14 publications

(7 citation statements)

References 15 publications

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“…Mark and McCulley9 have also cited prodromal conjunctivitis, subepithelial and anterior stromal infiltrates in two patients with Reiter’s syndrome. However, to our knowledge, this is the first documented case of bilateral diffuse interstitial keratitis presenting in combination with anterior stromal infiltrates, preceded by consecutive conjunctivitis and epithelial involvement, during an initial episode of reactive arthritis.…”

Section: Discussionmentioning

confidence: 99%

Bilateral interstitial keratitis with anterior stromal infiltrates associated with reactive arthritis

Hsing¹,

Walker²

2017

BMJ Case Reports

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A previously healthy 48-year-old man presented with a 1-week history of migrating polyarthropathy preceded by a viral illness, dysuria and bilateral red eyes. Ocular examination revealed anterior and interstitial stromal keratitis. He was systemically well but had raised erythrocyte sedimentation rate and C reactive protein and was positive for human leucocyte antigen B27 on extensive infective, rheumatological and autoimmune investigations. Although the exact triggering pathogen was not identified, clinical findings were consistent with reactive arthritis. Bilateral interstitial keratitis is a rare manifestation of reactive arthritis which, along with the anterior stromal keratitis, responded well to topical prednisolone sodium phosphate 0.5%. Systemic joint symptoms improved on oral sulfasalazine, non-steroid anti-inflammatory agent and low-dose prednisolone.

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Section: Discussionmentioning

confidence: 99%

Bilateral interstitial keratitis with anterior stromal infiltrates associated with reactive arthritis

Hsing¹,

Walker²

2017

BMJ Case Reports

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“…However, keratitis and corneal ulcer are unusual ocular manifestations of ReA at initial presentation. [4][5][6][7][8][9][10][11] We have presented this case because there seemed to be a coexistence of infectious and immunemediated keratitis in this patient.…”

Section: Discussionmentioning

confidence: 99%

“…In ReA, the spectrum of keratitis has been described from mild pleomorphic stromal keratitis to corneal ulcers. [4][5][6][7][8][9][10][11] Keratitis in ReA is rare and mostly manifests as a mild pleomorphic anterior stromal keratitis seen in young men, [4][5][6][7][8] with corneal ulcers being distinctly rare. 7,10 We present here the case of a corneal ulcer as an ocular manifestation of ReA.…”

Section: Introductionmentioning

confidence: 99%

Corneal Ulcer in Reactive Arthritis

Behera¹,

Madhuri²,

Panicker³

et al. 2021

Journal of the Royal College of Physicians of Edinburgh

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A 20-year-old male presented with acute lower limb oligoarthritis and enthesitis followed by acute onset redness, watering, pain and decreased vision in the right eye. He had recent history of diarrhoea with fever. Erythrocyte sedimentation rate and high-sensitivity C-reactive protein (hsCRP) were raised and human leukocyte antigen-B27 was positive. The best corrected visual acuity (BCVA) in the right eye was 20/120 and it showed a paracentral shallow corneal ulcer of size 3 x 4 mm with underlying dense stromal infiltrates and haze. Microbiological evaluation of corneal scrapings was reported as Staphylococcus hominis. The epithelium healed on topical antibiotics in one week, but there were persistent punctate erosions and pleomorphic anterior stromal infiltrates and haze. The residual keratitis healed completely on topical steroids in ten days, with BCVA improving to 20/20. A diagnosis of reactive arthritis with immune-mediated keratitis was made.

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“…In this, an allogen in anterior chamber triggers a systemic immune response that leads to antigen specific suppression of delayed-type hypersensitivity and deviation to non-complement fixing antibody isotope. 3 Suresh in 2016 reported bilateral disciform keratitis in a 13 year old boy, with intact epithelium in one eye and entire corneal involvement with epithelial defect and hypopyon in the other. 4 Khandgave in 2015 reported bilateral disciform keratitis in a 13 year old girl, nonresponsive to antivirals but improved only by systemic and topical steroids.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Disciform Keratitis with Immune Corneal Ring in a Patient with HLA-B27 Positive Reactive Arthritis

Narayanan¹

2019

Delhi Journal of Ophthalmology

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Purpose: To report a presentation of bilateral disciform keratitis with immune corneal ring in a young male with HLA B 27 positive reactive arthritis. Case Report: A 21 year old man suffered an attack of bacterial UTI a month back with concurrent self-limited bilateral scleritis for 3 days. A week later, he developed multiple joint aches and a rheumatologist diagnosed HLAB27 associated reactive arthritis for the first time, though he had occasional mild joint aches for 8 years and was on irregular aurvedic medication. Specific treatment led to remission of arthritis. About 2 weeks later, he had second episode of bilateral red eye with blurry vision along with self-limited genital ulcer. With no improvement using topical and systemic antivirals for 3 days, he reported to us with bilateral disciform keratitis with incomplete immune rings. Preliminary smear reports of corneal scraping and conjunctival swab were negative and the patient was started on topical antibiotics and later tapering dose of topical steroids were added that led to complete resolution in 45 days. Conclusion: This is the first report of immune corneal ring in bilateral disciform keratitis in a patient with HLAB27 positive reactive arthritis to the best of our knowledge.

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Reiter's Keratitis

Cited by 14 publications

References 15 publications

Bilateral interstitial keratitis with anterior stromal infiltrates associated with reactive arthritis

Bilateral interstitial keratitis with anterior stromal infiltrates associated with reactive arthritis

Corneal Ulcer in Reactive Arthritis

Bilateral Disciform Keratitis with Immune Corneal Ring in a Patient with HLA-B27 Positive Reactive Arthritis

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