alexa Bilateral Scleromalacia Perforans in Rheumatoid Arthritis

Immunological Disorders & Immunotherapy

  • Clinical Image   
  • Immunol Disord Immunother 2017, Vol 2(3): 116

Bilateral Scleromalacia Perforans in Rheumatoid Arthritis

Mariam Chekhchar*, Abdelouahed Arfaja, Soulayman Ajdakar, Yassine Elghani, Ibtissam Hajji and Abdeljalil Moutaouakil
Department of Ophthalmology, Arrazi Hospital, Marrakech, Morocco
*Corresponding Author: Mariam Chekhchar, Department of Ophthalmology, Arrazi Hospital, Marrakech, Morocco, Tel: 212661560412, Email: [email protected]

Received Date: Nov 17, 2017 / Accepted Date: Nov 23, 2017 / Published Date: Nov 27, 2017

Clinical Image

Scleromalacia perforans is a type of anterior necrotizing scleritis without inflammation resulting in progressive scleral thinning. This rare severe form of scleritis can be attributed to vasculitis, which may be a result of immune complex-mediated pathogenesis. Scleromalacia perforans can be idiopathic or secondary to other autoimmune diseases, including rheumatoid arthritis, Crohn’s disease, ulcerative colitis, vasculitis, and systemic lupus erythematosus.

Rheumatoid arthritis is a systemic disease with manifestations in many organs. Ophthalmic presentations include Sjogren’s syndrome, episcleritis, and scleritis. The most severe form of scleritis, scleromalacia perforans, is a very rare ophthalmic manifestation. We present the case of a 70-year-old female patient who had rheumatoid arthritis for more than 13 years. She had bilateral scleromalacia perforans but no other extra-articular manifestations. She complained of discomfort and mild pain in both eyes of 3 months duration.

Right eye

Corrected visual acuity was 1/10, Sclera thinning in upper nasal quadrant with visible uveal tissue and no signs of inflammation was noted (Figure 1). Anterior chamber, iris and pupil were normal. Posterior subscapsular cataract was present. Applanation tension (intraocular pressure) was 12 mmHg.

immunological-disorders-immunotherapy-scleral-thinning

Figure 1: Right eye showing scleral thinning in the upper nasal quadrant with visible uveal tissue.

Left eye

Corrected visual acuity was 1/10. Scleral thinning with visible uveal tissue and no signs of inflammation was noted in upper temporal quadrant (Figure 2). Anterior chamber, iris and pupil were normal. Posterior subcapsular cataract was present. Applanation tension (intraocular pressure) was 13 mmHg. Fundus examination, after dilating the pupils did not show any abnormality in both eyes.

immunological-disorders-immunotherapy-temporal-quadrant

Figure 2: Left eye showing scleral thinning in the upper temporal quadrant with visible uveal tissue.

Conflict of Interest

The authors disclose no financial or proprietary conflicts of interest with this publication.

Citation: Chekhchar M, Arfaja A, Ajdakar S, Elghani Y, Hajji I, et al. (2017) Bilateral Scleromalacia Perforans in Rheumatoid Arthritis. Immunol Disord Immunother 2:116.

Copyright: © 2017 Chekhchar M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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