Effect of Anti-TNF Treatment on Mooren's Ulcer: A Case Series and Review of the Literature

We present our experience with five patients treated with anti-tumor necrosis factor alpha (TNF-alpha) agents who were unresponsive to conventional treatment. Additionally, we summarize the current experience with biological disease-modifying anti-rheumatic drugs (bDMARDs) in Mooren's ulcer. Purpose To report the efficacy of systemic anti-TNF agents in Mooren's ulcer. Design Retrospective, consecutive case series. Methods We report on clinical characteristics and outcome of five patients with Mooren's ulcer with anti-TNF treatment. Results During a mean follow-up of 30 months, relief of symptoms and arrest of corneal melting were observed in all eyes. Systemic corticosteroid treatment could be discontinued or reduced to threshold levels. No patient experienced adverse effects on bDMARDs. Conclusions Our results suggest that bDMARDs are effective in Mooren's ulcer unresponsive to conventional treatment. This is in line with accumulating evidence in the current literature. Therefore, more targeted immunomodulatory approaches might be an effective first-line therapy in the future.

Automated summary

In this study, we retrospectively analyzed the experience of using anti-tumor necrosis factor alpha (TNF-alpha) agents in five patients with Mooren's ulcer who were unresponsive to conventional treatment. The results showed that anti-TNF treatment effectively relieved symptoms and stopped corneal melting without adverse effects. These findings suggest that anti-TNF agents are a viable treatment option for Mooren's ulcer that does not respond to conventional therapy, providing new insights for future management.