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Maite Sainz de la Maza, Nicolas Molina, Luis A. Gonzalez, Priyanka P. Doctor, Joseph Tauber, C Stephen Foster; Clinical Characteristics of a Large Cohort of Patients with Scleritis and Episcleritis. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1137.
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To evaluate the demographic characteristics, clinical features, ocular complications, disease associations and risk factors for visual deterioration in patients with scleritis and episcleritis
Retrospective case series. We reviewed the electronic health records of 500 patients with scleritis and 85 patients with episcleritis seen at two tertiary referral centers. Outcome measures included clinical features, ocular complications and systemic disease associations. Chi-square test, Kruskal-Wallis test, Mann-Whitney U test, and logistic regression were used for statistic analysis.
Of 585 patients, 500 patients had scleritis (85.5%) and 85 patients had episcleritis (14.2%). Ocular complications were more frequent in patients with scleritis vs. episcleritis (45.0% vs. 19.0%), including decrease in vision (15.8% vs. 2.3%), anterior uveitis (26.4% vs. 16.5%), peripheral ulcerative keratitis (7.4% vs. 0%), and ocular hypertension (14.2% vs. 3.5%) (P<0.0001 for each). Disease association was observed in 35.8% of patients with scleritis vs. 27.1% of episcleritis patients. Ocular complications (90.0%) and association with systemic disease (80.0%) occurred most often in patients with necrotizing scleritis (P<0.0001). Risk factors for decrease in vision included necrotizing scleritis (OR=6.63, P=0.042), degree of scleral inflammation >2+ (OR=3.60, P<0.001), associated anterior uveitis (OR=1.78, P=0.033), associated ocular hypertension (OR=3.19, P<0.001), and associated infectious disease (OR=4.44, P<0.001).
Scleritis is more often associated with ocular complications than episcleritis; necrotizing scleritis is most often associated with ocular complications and systemic diseases. Risk factors for decrease in vision in patients with scleritis include necrotizing scleritis, posterior scleritis, scleral inflammation>2+, anterior uveitis, ocular hypertension, and associated infectious disease.
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