A 52-year-old woman with RA was diagnosed with rheumatoid factor and rheumatoid factor high titres and anti-cyclic citrullinated peptide (anti-CCP) antibodies with a 12-year history of failure secondary to infliximab and adalimumab.
You have red eye, pain, and photophobia
Peripheral corneal infiltrate in semiluna associated with scleritis.
Negative corneal scraping culture.
We started treatment with prednisone 1mg/kg/day orally and switched therapeutic target to rituximab at the usual dose in RA with methotrexate 25mg/week.
After the first cycle of rituximab, the patient experienced great improvement with healing of QUP and clinical remission of RA.
After 10 months, a corneal infiltrate and mild scleritis appeared again and joint symptoms began.
We decided to continue treatment with i.v. rituximab for RA every 8 months with good clinical control of both ocular and systemic symptoms.
