title: Use of infliximab in the treatment of peripheral ulcerative keratitis in Crohn disease.
abstract: OBJECTIVE
  To report the effectiveness of infliximab in the treatment of peripheral ulcerative keratitis (PUK) associated with Crohn disease.
  
  
  METHODS
  Retrospective, interventional case series.
  
  
  METHODS
  
  
  
  METHODS
  Institutional, academic referral setting. patient or study population: Six eyes of 3 patients with PUK associated with Crohn disease that failed or were intolerant to traditional immunosuppression such as oral prednisone and cyclophosphamide. INTERVENTION OR OBSERVATION PROCEDURE(S): Infliximab intravenous infusion 5 mg/kg every 2 to 8 weeks.
  
  
  METHODS
  Subjective outcome such as pain improvement and objective outcomes such as visual acuity, signs of inflammation, and progression of corneal thinning.
  
  
  RESULTS
  Symptom of pain improved in all patients. Visual acuity remained stable in 4 of 6 eyes, improved in 1 of 6 eyes, and worsened in 1 of 6 eyes (secondary to stromal scar). Rapid resolution of inflammation and arrest of further thinning were observed in all 6 eyes. Similar effects were observed on recurrence treated with repeat dosing of infliximab in 5 of 6 eyes.
  
  
  CONCLUSIONS
  Infliximab produced a rapid, dramatic, repeatable suppression of corneal inflammation, pain, and keratolysis in PUK associated with Crohn disease. Although the effect of long-term therapy with these agents is unknown, infliximab should be considered in patients with Crohn-associated PUK not amenable to traditional therapy. Larger prospective studies are needed to determine the efficacy of infliximab in this aggressive disease entity.
authors.affiliation: Illinois Eye and Ear Infirmary, Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois 60612, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Pham
authors.forename: Clement C
authors.initials: CC
authors.lastname: Chow
authors.forename: David
authors.initials: D
authors.lastname: Badawi
authors.forename: Elmer Y
authors.initials: EY
authors.lastname: Tu
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D003320:Corneal Ulcer / Q000188:drug therapy* / Q000503:physiopathology; D003424:Crohn Disease / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D000069285:Infliximab; D007262:Infusions, Intravenous; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D000069285:Infliximab