Spontaneous corneal perforation in treatment‐resistant MPO‐ANCA‐associated small vessel vasculitis

Abstract

AbstractPurpose: Spontaneous corneal perforation is a rare complication in peripheral ulcerative keratitis (PUK). Identifying the systemic cause of PUK is essential for optimal treatment. MPO‐ANCA‐associated small vessel vasculitis is a potential cause of PUK. Being an autoimmune disorder, immunosuppressive therapy is indicated. Besides steroids, biologicals such as rituximab can be used with excellent results.Methods: In this case report, we would like to present a 83‐year‐old male patient with PUK caused by MPO‐ANCA‐positive small vessel vasculitis.Results: In this patient with PUK due to small vessel vasculitis, a spontaneous corneal perforation could not be prevented despite maximal immunosuppressive therapy. Thus, a tectonic penetrating keratoplasty à chaud was inevitable.Conclusions: Ophthalmologists should be aware of the rare complication of corneal perforation secondary to PUK caused by vasculitis.