Peripheral ulcerative keratitis in rheumatoid arthritis: successful use of intravenous cyclophosphamide and comparison of clinical and serological characteristics.

P eripheral ulcerative keratitis (PUK) is a devastating complication of rheumatoid arthritis (RA) that can lead to rapid corneal destruction (corneal melt) and perforation with loss of vision (fig 1). It is well reported to herald systemic vasculitis and carries a high mortality rate if not aggressively treated. There is a paucity of information concerning the clinical and serological characteristics of these patients and no clear consensus about treatment. We report the successful management of seven such patients with the use of intravenous cyclophosphamide and compare the serological and clinical characteristics with a comparative group of 150 rheumatoid patients without associated PUK, who attended an outpatient clinic.