Purchase this article with an account.
V. R. Raiji, A. G. Palestine, D. L. Parver; Scleritis And Systemic Disease Association in a Non-tertiary Referral Center. Invest. Ophthalmol. Vis. Sci. 2009;50(13):280.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate the association between scleritis and systemic disease in a non-university, non-tertiary referral practice and to better delineate the role of TNF alpha-inhibitor biologics in the treatment of steroid-refractory scleritis.
Medical records of patients with scleritis from 2001-2007 were reviewed for associated autoimmune disease.
In our series of 86 patients with scleritis, 55 patients (64%) had isolated scleritis while 31 patients (36.0%) had associated systemic-disease. Twenty-six (83.9%) patients with systemic disease-associated had diagnosed systemic disease at the time of initial scleritis presentation, while 5 patients (16.1%) were diagnosed following systemic work-up, these patients were more likely to have systemic vasculitic disease as opposed to a rheumatic or infectious disease. Patients with and without associated systemic disease were likely to require systemic therapy at similar rates (93.5%, 92.7% respectively). Five patients with steroid-refractory scleritis were treated with Remicade (infliximab, Centocor, Inc.) and all responded without evidence of adverse effect. CellCept (mycophenolate mofetil, Roche Laboratories) was used in 7 patients, of which 3 improved.
The association between scleritis and systemic disease in a non-referral practice may be lower than in tertiary referral centers. Although thorough systemic disease evaluation is warranted in patients presenting with scleritis, most patients with associated systemic disease will have a diagnosis prior to the development of scleritis. The need to institute aggressive systemic therapy cannot be predicted by presence of associated systemic disease. Infliximab and mycophenolate mofetil are useful additions to the scleritis-practitioner’s armamentarium for steroid-refractory scleritis.
This PDF is available to Subscribers Only