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KYUHWAN JANG, Hyun Sun Jeon, Joon-Young Hyon, Mee Kum Kim; Clinical characteristics and treatment outcomes of necrotizing scleritis- A multi-center retrospective analysis in Korea. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):6214.
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We performed a retrospective, case series study to describe the clinical characteristics of necrotizing scleritis and to analyze the factors associated with treatment outcomes.
Medical charts of fifty-two patients who diagnosed with necrotizing scleritis and treated with immunosuppressive agent (ISA) and followed up at least 3 months from June 2002 to May 2012 at eleven tertiary-care centers in Korea were reviewed. Patient characteristics, clinical features, predisposing factors, and treatment outcomes were analyzed.
The mean age was 65.8 ± 10.5 years. Prior ocular surgery (46 eyes, 88.5%), especially pterygium excision (42 eyes, 80.8%) accounted for the majority of cases. The mean visual acuity of affected eyes was lower than contralateral eyes (0.62 ± 0.76, p <0.01). Scleral injection and thinning were the most frequently at the nasal side (43 eyes, 82.7%). 17 patients (32.7%) required surgical treatment. Disease remission was induced in 90% of patients at 6 months, 95% at 12 months. Patients who have fair visual acuity (> 20/200) at initial presentation and who were given ISA within 2 weeks showed faster remission (P=0.012, P=0.043, respectively). Initial treatment with steroids or ISA showed better clinical outcome compared to NSAID (P=0.03).
Necrotizing scleritis was frequently associated with prior ocular surgery. Although long term treatment was required, the most of patients could achieve favorable outcomes. Early administration of systemic ISA and good initial visual acuity were associated with better clinical results.
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