Mooren ulcer in South India: Serology and clinical risk factors

PURPOSE: To investigate the rare of undiagnosed rheumatologic diseases and hepatitis C infection among patients with the clinical diagnosis of Mooren ulcer seen at Aravind Eye Hospital, Madurai, South India. METHODS: Twenty-one patients with the clinical diagnosis of Mooren ulcer an d 44 control patients underwent a complete ophthalmic history and examinati on, as well as serologic testing for antinuclear antibodies, rheumatoid fac tor, antineutrophil cytoplasmic antibodies, herpes simplex virus 1 antibodi es, and hepatitis C virus antibodies. RESULTS: There were no statistically significant differences in the rates o f seropositivity for antinuclear anti bodies, rheumatoid factor, antineutro phil cytoplasmic antibodies, herpes simplex virus 1 antibodies, and hepatit is C virus antibodies between patients with Mooren ulcer and control patien ts. Two patients with Mooren ulcer and four control patients were found to have a rheumatoid factor titer of greater than 1:20. One of the control pat ients, but none of the patients with Mooren ulcer, was found to have serolo gic evidence of hepatitis C infection. A history of corneal trauma, surgery , or infection was reported by 68% of patients with Mooren ulcer, compared with 20% of control patients (P < .001), Among patients with Mooren ulcer, bilateral disease occurred in 37% of patients, visual acuity was reduced to light perception in 15% of eyes, and perforation occurred in 19% of eyes. CONCLUSIONS: Nineteen (90%) of 21 patients with the clinical diagnosis of M ooren ulcer were found to have no evidence of an underlying rheumatologic d isease by history, examination, or serologic testing, and none was seroposi tive for hepatitis C, However, patients with Mooren ulcer were more likely than control patients to report a history of corneal trauma, surgery, or in fection. (C) 1999 by Elsevier Science Inc. All rights reserved.