Spontaneous corneal perforation in treatment-resistant MPO-ANCAassociated small vessel vasculitis

Spontaneous corneal perforation is a rare complication in sterile ulcerative keratitis [1]. Identifying the systemic causes is essential for optimal treatment. Anti-myeloperoxidase antibodies (MPO) are a subcategory of perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA). MPO-ANCA-associated small vessel vasculitis is a potential cause of sterile ulcerative keratitis. Being an autoimmune disorder, immunosuppressive therapy is indicated. Besides steroids, biologicals such as rituximab can be used with excellent results [2], [3].