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Case Reports
. 2025 Jul 20;8(3):115.
doi: 10.3390/reports8030115.

Rituximab Therapy in Refractory Ocular Cicatricial Pemphigoid: A Case Report

Sania Vidas Pauk  1 , Antonela Geber  1 , Iva Bešlić  1 , Ines Lakoš-Jukić  2 , Tomislav Kuzman  1
Affiliations
Case Reports

Rituximab Therapy in Refractory Ocular Cicatricial Pemphigoid: A Case Report

Sania Vidas Pauk et al. Reports (MDPI). .

Abstract

Background and Clinical Significance: Ocular cicatricial pemphigoid (OCP) is a rare autoimmune disease affecting the conjunctiva and oral mucosa. Chronic inflammation causes conjunctival scarring, leading to symblepharon, trichiasis, corneal damage, and possible blindness. Diagnosis is clinical, supported by biopsy and immunofluorescence. Treatment includes systemic corticosteroids, immunosuppressants, and biologics in refractory cases. Case Presentation: A 64-year-old male presented with ocular irritation, trichiasis, and counting fingers (CF) visual acuity in the left eye. Slit-lamp examination revealed conjunctival inflammation, corneal epithelial defect, and symblepharon in the left eye. Biopsy confirmed ocular cicatricial pemphigoid (OCP). He was treated with topical steroids, cyclosporine, subconjunctival injections, and systemic corticosteroids, followed by surgery, which improved BCVA to 0.10 logMAR. Two years later, disease progression resulted in severe inflammation and visual decline in both eyes. Systemic azathioprine and corticosteroids achieved partial control. Due to insufficient response, rituximab therapy was initiated, leading to significant reduction in inflammation and stabilization of disease. Right eye BCVA improved to 0.16 logMAR; the left remained at CF. The patient continues to receive rituximab during exacerbations and is under regular follow-up. Conclusions: Early diagnosis and timely systemic treatment are essential in preventing vision loss in OCP. In refractory cases, biologic agents like rituximab may offer effective disease control.

Keywords: biologic therapy; mucous membrane pemphigoid; ocular cicatricial pemphigoid; rituximab.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Severe inflammation with corneal neovascularization, keratinization, and ankyloblepharon in the left eye.
Figure 2
Figure 2
Conjunctivitis with symblepharon in the right eye.
Figure 3
Figure 3
(a,b) Left eye after rituximab therapy.
Figure 4
Figure 4
(a,b) Right eye after rituximab therapy.
See this image and copyright information in PMC

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References

    1. Stan C., Diaconu E., Hopirca L., Petra N., Rednic A., Stan C. Ocular cicatricial pemphigoid. Rom. J. Ophthalmol. 2020;64:226–230. doi: 10.22336/rjo.2020.38. - DOI - PMC - PubMed
    1. Hingorani M., Lightman S. Ocular cicatricial pemphigoid. Curr. Opin. Allergy Clin. Immunol. 2006;6:373–378. doi: 10.1097/01.all.0000244799.33734.d4. - DOI - PubMed
    1. Ahmed A.R., Kurgis B.S., Rogers R.S. Cicatricial pemphigoid. J. Am. Acad. Dermatol. 1991;24:987–1001. doi: 10.1016/0190-9622(91)70159-Y. - DOI - PubMed
    1. Branisteanu D.C., Stoleriu G., Branisteanu D.E., Boda D., Branisteanu C.I., Maranduca M.A., Moraru A., Stanca H.T., Zemba M., Balta F., et al. Ocular cicatricial pemphigoid (Review) Exp. Ther. Med. 2020;20:3379–3382. doi: 10.3892/etm.2020.8972. - DOI - PMC - PubMed
    1. Messmer E.M., Hintschich C.R., Partscht K., Messer G., Kampik A. Okuläres vernarbendes Pemphigoid. Ophthalmologe. 2000;97:113–120. doi: 10.1007/s003470050021. - DOI - PubMed

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