April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Infectious scleritis. Clinical characteristics and ethiology
Author Affiliations & Notes
  • Elsa Maria Flores Reyes
    Ophthalmology, Instituto de Oftalmologia Conde de Valenciana, Mexico City, Mexico
  • Vanessa Valderrama Albino
    Uveitis and Ocular Inmunology, Institute of Ophthalmology Conde de Valenciana, Mexico City, Mexico
  • Miguel Pedroza-Seres
    Uveitis and Ocular Inmunology, Institute of Ophthalmology Conde de Valenciana, Mexico City, Mexico
  • Footnotes
    Commercial Relationships Elsa Maria Flores Reyes, None; Vanessa Valderrama Albino, None; Miguel Pedroza-Seres, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 1575. doi:
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      Elsa Maria Flores Reyes, Vanessa Valderrama Albino, Miguel Pedroza-Seres; Infectious scleritis. Clinical characteristics and ethiology. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1575.

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Abstract
 
Purpose
 

To describe the clinical and epidemiological features, pathogenic organisms and the outcomes in cases of infectious scleritis

 
Methods
 

Retrospective chart review of all patients with infectious scleritis examined from 2009 to 2013 in the Uveitis and Ocular Inmunology Department of Institute of Ophthalmology, “Conde de Valenciana,” Mexico City, Mexico. Information including epidemiological and clinico-microbiological data were abstracted from the records

 
Results
 

A total of 362 patients were included, seventy nine had episcleritis (23,1%) and two hundred and sixty three had scleritis (76,9%). Infectious scleritis was found in thirteen cases (12 anterior and 1 posterior scleritis). Among them, mean age was 48.15 years (±17,8), with no sex predominance (6 males and 7 females). Mean time since onset was 45 days (±31), with clinical features characterized by hiperemia (92,3%), ocular pain (84,6%) and decrease in vision (53,8%). Average visual acuity was 0,43 logMAR ±0,79 and 0,54 logMAR ± after full treatment We found four patients with herpetic scleritis, 3 of them had also skin, corneal and uveal involvement. All of these patients received medical treatment with oral Aciclovir during 2,75 months in average with fully recovery. Three patients were clasified as having mycobacterial scleritis, two of them with associated uveítis; in all cases diagnosis was confirmed by a PPD ≥10mm and clinical cure after antifimic therapy. Six patients presented a scleral infection caused by normal bacterial flora Grampositive cocci (5) and one by Pseudomonas spp. Risks factors for bacterial infection were identified in three of them, such as previous pterigyum surgery, inmunosupression, and a previous periocular injection treatment. None of them had keratitis or endophtalmitis associated and responded well to medical treatment guided by antibiogram results. Surgical exploration or biosy was not necessary in any of the patients. Main complications were cataracts (3), retinal detachment(1) and secondary glaucoma(1)

 
Conclusions
 

Infectious scleritis represents a diagnostic challenge. Prior ocular surgery or trauma and inmunosupresion treatment for sistemic conditions must be considered as risk factors for an infectious origin. Early recognition and appropriate treatment improve visual outcome

     
Keywords: 708 sclera • 745 uvea • 462 clinical (human) or epidemiologic studies: outcomes/complications  
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