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Case of isolated scleromalacia perforans with seropositivity for rheumatoid arthritis
  1. Sama Hajizadeh1,
  2. Conor O'Donnell2 and
  3. Adam Dore2
  1. 1Internal Medicine, Allegheny Health Network, Pittsburgh, Pennsylvania, USA
  2. 2Allegheny Health Network, Pittsburgh, Pennsylvania, USA
  1. Correspondence to Dr Sama Hajizadeh; sama.hzh{at}


Scleromalacia perforans, or necrotising anterior scleritis, is a rare and severe form of eye disease that usually occurs in patients suffering from long-standing systemic inflammatory diseases, with rheumatoid arthritis (RA) being the most common. Here, we report the case of a patient who presented with redness of the eye and discolouration of the sclera and was diagnosed with scleromalacia perforans without any further extraophthalmic systemic involvement. Serological workup revealed highly positive cyclic citrullinated peptide (CCP) antibody (CCP-IgG/anticitrullinated protein antibodies) and positive rheumatoid factor, serologies commonly associated with RA. The patient’s symptoms responded very well to rituximab therapy.

  • Rheumatoid arthritis
  • Ophthalmology
  • Autoimmunity
  • Biological agents

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  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content. SH: drafted the text and edited the text and image. CO'D: sourced image and reviewed and revised the text. AD: reviewed and revised the text. The following authors gave final approval of the manuscript: all authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.