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Behçet’s Disease: A Case of Peripheral Ulcerative Keratitis Leading to Corneal Perforation. Selcuk Sizmaz, Aysel Pelit, Meltem Yagmur, Didem Arslan, Yonca Aydin Akova. None of the authors have any financial or proprietary interest in any material used in the study. A 27 year-old man

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Beh et s disease a case of peripheral ulcerative keratitis leading to corneal perforation

Behçet’s Disease: A Case of Peripheral Ulcerative Keratitis Leading to Corneal Perforation

Selcuk Sizmaz, Aysel Pelit, Meltem Yagmur, Didem Arslan, Yonca Aydin Akova

None of the authors have any financial or proprietary interest in any material used in the study


  • A 27 year-old man Keratitis Leading to Corneal Perforation

  • Two day history of redness in the right eye

  • Corneal thinning involving the anterior stroma and adjacent conjunctival hyperemia, in the corneal limbus, at the 2- to 3-o’clock quadrant

  • No sign of dry eye

  • Topical ofloxacin and artificial tears prescribed



  • Two days later Keratitis Leading to Corneal Perforation

    • Corneal perforation

    • İris prolapsed



Ophthalmic and systemic evaluation
Ophthalmic and systemic evaluation Keratitis Leading to Corneal Perforation

  • No significant ocular history

  • Oral aphthous lesions that had occurred once or twice a month for the previous 2 years

  • Eight years history of lower back and buttock pain with morning stiffness for 30 minutes

  • Arthralgia in the knee joints without swelling


  • Arterial BP (mmHg) Keratitis Leading to Corneal Perforation

    • 130/80 right arm

    • 100/70 left arm

  • Weak pulse in left arm

  • Colour Doppler USG: left subclavian artery narrowing

  • MR angipgraphy: 4 cm-long diffuse stenosis in left subclavian artery

  • Sacroiliac graphy: grade II-III sacroiliitis

  • Pathergy test: (-)


Diagnosis beh et s disease
Diagnosis: Behçet’s disease Keratitis Leading to Corneal Perforation

  • Oral aphthous lesions

  • Ocular involvement

  • Large vessel vasculitis

  • Sacroiliitis


  • Management: Keratitis Leading to Corneal Perforation

    • Methylprednisolone, 32 mg/day, po; tapered

    • Azathioprine, 150 mg/day, po

  • Prognosis (1 year follow-up):

    • No recurrence

    • Systemic symptoms improved


Differential diagnosis
Differential diagnosis Keratitis Leading to Corneal Perforation

  • Takayasu arteritis

    • Aorta and branches involved

    • No aphthous lesions

    • Sacroiliitis uncommon

    • Ocular invovement rare

  • Polyarteritis nodosa

    • Peripheral ulcerative keratitis occurs

    • Predominantly females

    • Aneurisms in small-middle sized vessels

    • Constitutional symptoms


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