Delay of corneal wound healing in patients treated with colchicine.
BACKGROUND
Colchicine has a known adverse effect on wound healing through its inhibitory effect on tubulin-dependent cell functions and through collagenase activation. In the cornea, it has been shown in animal and in vitro studies to inhibit epithelium mitosis, fibroblast mitosis and migration, as well as to reduce collagen deposition. The authors report on two patients with corneal ulcers refractory to conventional treatment while the patients were undergoing oral colchicine therapy.


METHODS
The first patient was an 86-year-old woman who had been treated with oral colchicine because of rheumatoid arthritis. She was admitted to the authors' department with a deep corneal ulcer in the right eye for which she had been treated for 3 weeks with local antibiotics without any improvement. The second patient, a 60-year-old woman, was hospitalized because of a corneal ulcer in her left eye. She had been receiving oral colchicine therapy for mixed connective tissue disease. Treatment with local antibiotics was initiated but the condition of the eye worsened, ultimately resulting in corneal perforation.


RESULTS
Withdrawal of oral colchicine therapy was followed by rapid corneal wound healing in both patients.


CONCLUSIONS
The findings in these two patients suggest that colchicine may delay corneal wound healing. The authors suggest that in patients with corneal ulcers refractory to conventional treatment who are receiving colchicine, cessation of colchicine therapy should be considered.
Alster
Y
Y
Department of Ophthalmology, Tel-Aviv Sourasky Medical Center, Tel-Aviv University, Israel.
Varssano
D
D
Loewenstein
A
A
Lazar
M
M
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D003078:Colchicine / Q000009:adverse effects* / Q000627:therapeutic use; D003315:Cornea / Q000187:drug effects / Q000503:physiopathology*; D003320:Corneal Ulcer / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D011241:Prednisone / Q000627:therapeutic use; D014945:Wound Healing / Q000187:drug effects* / Q000502:physiology
D000900:Anti-Bacterial Agents; D018501:Antirheumatic Agents; D005839:Gentamicins; D005938:Glucocorticoids; D003078:Colchicine; D011241:Prednisone