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. 2014 Jan 22;2014(1):CD006131.
doi: 10.1002/14651858.CD006131.pub3.

Interventions for Mooren's ulcer

Mahmoud B Alhassan  1 , Mansur Rabiu, Idris O Agbabiaka
Affiliations

Interventions for Mooren's ulcer

Mahmoud B Alhassan et al. Cochrane Database Syst Rev. .

Abstract

Background: Mooren's ulcer is a chronic, painful peripheral ulcer of the cornea. Its cause is unknown but it can or will lead to loss of vision if untreated. Severe pain is common in patients with Mooren's ulcer and the eye(s) may be intensely reddened, inflamed and photophobic, with tearing. The disease is rare in the northern hemisphere but more common in southern and central Africa, China and the Indian subcontinent. There are a number of treatments used such as anti-inflammatory drugs (steroidal and non-steroidal), cytotoxic drugs (topical and systemic), conjunctivectomy and cornea debridement (superficial keratectomy). There is no evidence to show which is the most effective amongst these treatment modalities.

Objectives: The aim of this systematic review is to assess the effectiveness of the various interventions (medical and surgical) for Mooren's ulcer.

Search methods: We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2013, Issue 5), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to June 2013), EMBASE (January 1980 to June 2013), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to June 2013), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 4 June 2013.

Selection criteria: We planned to include randomised controlled trials (RCTs) or discuss any prospective non-RCTs in the absence of any RCTs. The trials included would be of people of any age or gender diagnosed with Mooren's ulcer and all interventions (medical and surgical) would be considered.

Data collection and analysis: Two authors screened the search results independently; we found no studies that met our inclusion criteria.

Main results: As we found no studies that met our inclusion criteria, we highlighted important considerations for conducting RCTs in the future in this area.

Authors' conclusions: We found no evidence in the form of RCTs to assess the treatment effect for the various interventions for Mooren's ulcer. High quality RCTs that compare medical or surgical interventions across different demographics are needed. Such studies should make use of various outcome measures, (i.e. healed versus not healed, percentage of area healed, speed of healing etc.) as well as ensuring high quality randomisation and data analysis, as highlighted in this review .

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Conflict of interest statement

None known.

Figures

1
1
Results from searching for studies for inclusion in the review.
See this image and copyright information in PMC

Update of

References

References to studies excluded from this review

Brown 1975 {published data only}
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Chen 2000 {published data only}
    1. Chen J, Xie H, Wang Z, Yang B, Liu Z, Chen L, et al. Mooren's ulcer in China: a study of clinical characteristics and treatment. British Journal of Ophthalmology 2000;84(11):1244‐9. - PMC - PubMed
Chen 2004 {published data only}
    1. Chen KH, Hsu WM, Liang CK. Relapsing Mooren's ulcer after amniotic membrane transplant combined with conjunctival autograft. Ophthalmology 2004;111(4):792‐5. - PubMed
Chow 1996 {published data only}
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Fontana 2007 {published data only}
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Kalogeropulous 2004 {published data only}
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Mavrakanas 2007 {published data only}
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Sangwan 1997 {published data only}
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Sharma 2005 {published data only}
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Tandon 2008 {published data only}
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Tiev 2003 {published data only}
    1. Tiev KP, Borderie VM, Briant M, Ziani M, Morvant C, Baret M, et al. Severe Mooren's ulcer: efficacy of monthly cyclophosphamide intravenous pulse treatment [Ulceres de Mooren severes: efficacite du traitement par cyclophosphamide en bolus intraveineux mensuels]. La Revue de Medecine Interne 2003;24(2):118‐22. - PubMed
Van der Hoek 2003 {published data only}
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Xie 2003 {published data only}
    1. Xie H, Chen J, Wang Z, Yang B, Gong X, Feng C, et al. Microsurgical treatment of bilateral Mooren's ulcer. Microsurgery 2003;23(1):27‐31. - PubMed
Zegans 1998 {published data only}
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Zhao 1993 {published data only}
    1. Zhao JC, Jin XY. Immunological analysis and treatment of Mooren's ulcer with cyclosporin A applied topically. Cornea 1993;12(6):481‐8. - PubMed

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References to other published versions of this review

Alhassan 2011
    1. Alhassan MB, Rabiu M, Agbabiaka IO. Interventions for Mooren's ulcer. Cochrane Database of Systematic Reviews 2011, Issue 6. [DOI: 10.1002/14651858.CD006131.pub2] - DOI - PubMed
Rabiu 2006
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