Corneal Melt Associated with Subcutaneous Allergen Immunotherapy
Corneal Melt and Allergen Immunotherapy
DOI:
https://doi.org/10.62856/djcro.v10.84Keywords:
allergies, corneal melt, immunologic trigger, subcutaneous allergen immunotherapy, peripheral ulcerative keratitisAbstract
Subcutaneous allergen immunotherapy (SCIT) is not typically associated with serious ocular complications. We report a 53-year-old male who developed corneal melt and was diagnosed with peripheral ulcerative keratitis (PUK) in the setting of SCIT for severe seasonal allergies. The patient presented with bilateral eye pain, redness, and photophobia following immunotherapy injections, with examination revealing a peripheral corneal melt in the right eye with thinning, neovascularization, and conjunctival overgrowth. Infectious and autoimmune workup was noncontributory. Treatment with oral and topical steroids and periocular tacrolimus was initiated, though incompletely effective. SCIT was then discontinued, resulting in resolution of the epithelial defect and ocular inflammation. We propose that SCIT acted as an immunologic trigger for corneal melt, potentially through a hyperreactive immune response and immune complex deposition in limbal vasculature. This case highlights the importance of monitoring for ocular complications during allergen immunotherapy and broadening the differential for corneal melt to include any potential immunologic disturbances.
Downloads
Downloads
Published
How to Cite
Issue
Section
License
The Contributor assigns to Duke, during the full term of copyright and any extensions or renewals, all copyright in and to the Manuscript, and all rights therein, including but not limited to the right to publish, republish, transmit, sell, distribute and otherwise use the Manuscript in whole or in part in electronic editions of the DJCRO and in derivative works throughout the world, in all languages and in all media of expression now known or later developed, and to license or permit others to do so. "Manuscript" means the article submitted by the Contributor for publication in the DJCRO (including any embedded rich media) and all subsequent versions. The definition of Manuscript does not extend to any supporting information submitted with or referred to in the Manuscript ("Supporting Information"). To the extent that any Supporting Information is submitted to the DJCRO, Duke is granted a perpetual, non-exclusive license to publish, republish, transmit, sell, distribute and otherwise use this Supporting Information in whole or in part in electronic and print editions of the DJCRO and in derivative works throughout the world, in all languages and in all media of expression now known or later developed, and to license or permit others to do so. If the Manuscript was shared as a preprint, the Contributor grants to Duke exclusivity as to any rights retained by the Contributor in the preprint.
Reproduction, posting, transmission or other distribution or use of the final Manuscript in whole or in part in any medium by the Contributor as permitted by this Agreement requires a citation to the DJCRO suitable in form and content as follows: (Contributor(s), Title of Manuscript, Journal Title, Journal Volume, Copyright© [year], Digital Object Identifier [DOI] link to final Manuscript). Links to the final article on the DJCRO website are also encouraged where appropriate.
