Corneal melt in rheumatic disorders: effect of disease-modifying antirheumatic drugs on morbidity.

Objective: The objective of this study was to review the characteristics of patients with corneal melt and to assess if treatment with disease-modifying antirheumatic drugs (DMARDs) improved the visual outcome.

Method: We did a retrospective analysis of patients diagnosed with corneal melt between 1976 and 2002. Twenty-one patients with rheumatoid arthritis and 5 patients with primary Sjögren syndrome (26 patients, 42 eyes) were included in the analysis of visual outcome. Visual outcome was described as "fair" if the corrected visual acuity was 20/200 or better and as "poor" if the corrected visual acuity was worse than 20/200.

Results: Visual outcome was fair in 9 patients (90%) in the DMARD group versus 2 patients (13%) in the no DMARD group (P= 0.001), and in 14 eyes (93%) in the DMARD group versus 7 eyes (26%) in the no DMARD group (P = 0.001).

Conclusion: The use of DMARDs improves visual outcome in patients with corneal melt.