Mooren ulcer in South India: serology and clinical risk factors.
OBJECTIVE
To investigate the rate 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 and 44 control patients underwent a complete ophthalmic history and examination, as well as serologic testing for antinuclear antibodies, rheumatoid factor, antineutrophil cytoplasmic antibodies, herpes simplex virus 1 antibodies, and hepatitis C virus antibodies.


RESULTS
There were no statistically significant differences in the rates of seropositivity for antinuclear antibodies, rheumatoid factor, antineutrophil cytoplasmic antibodies, herpes simplex virus 1 antibodies, and hepatitis C virus antibodies between patients with Mooren ulcer and control patients. 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 patients, but none of the patients with Mooren ulcer, was found to have serologic 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 Mooren ulcer were found to have no evidence of an underlying rheumatologic disease by history, examination, or serologic testing, and none was seropositive for hepatitis C. However, patients with Mooren ulcer were more likely than control patients to report a history of corneal trauma, surgery, or infection.
Zegans
M E
ME
The Francis I. Proctor Foundation and Department of Ophthalmology, University of California, San Francisco 94143-0944, USA.
Srinivasan
M
M
McHugh
T
T
Whitcher
J P
JP
Margolis
T P
TP
Lietman
T
T
Jennette
J C
JC
Cunningham
E T
ET
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000032:analysis*; D000974:Antibodies, Antinuclear / Q000032:analysis*; D000914:Antibodies, Viral / Q000032:analysis*; D003315:Cornea / Q000473:pathology; D003320:Corneal Ulcer / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006526:Hepatitis C / Q000276:immunology; D018937:Hepatitis C Antibodies / Q000032:analysis; D018259:Herpesvirus 1, Human / Q000276:immunology; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012217:Rheumatoid Factor / Q000276:immunology*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012698:Serologic Tests / Q000379:methods; D014792:Visual Acuity
D019268:Antibodies, Antineutrophil Cytoplasmic; D000974:Antibodies, Antinuclear; D000914:Antibodies, Viral; D018937:Hepatitis C Antibodies; D012217:Rheumatoid Factor