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MD AMIR ISMAIL, HELEN MI FANG, Rachel Lim, ELIZABETH WONG, SU LING HO, STEPHEN TEOH, Rupesh Vijay Agrawal; Trends in patterns of scleritis in a tertiary institution in Singapore. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1890.
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© ARVO (1962-2015); The Authors (2016-present)
To identify the characteristics, clinical features, systemic associations and treatment outcome of scleritis at a tertiary eye center in Singapore.
This was a retrospective analysis of the clinical records of consecutive new cases of ocular inflammation that presented to the uveitis subspecialty clinic from 2004–2014 at Tan Tock Seng Hospital, Singapore. Data collected included demographics, clinical and laboratory findings and management. Diagnoses were made based on standardized clinical history, ophthalmological examination and investigations. Data was analyzed with SPSS Statistics software, with quantitative variables expressed as mean with standard deviation and qualitative values as percentages.
120 patients with scleritis were identified from database of 1874 patients with uveitis seen over an 11-year period. 58.2% were females, while 41.8% Males, with a mean age of 48.59 (SD: 15.9). 69.2% of patients were Chinese, followed by Indians (12.5%), and Malay (11.7%). The disease was unilateral in 71.6% while bilateral in 28.4%. 62.5% had diffuse, 20.8% had nodular, 1.7% necrotizing, 4.2% scleromalacia perforans and 10.8% posterior scleritis. The commonest presenting complaints included eye redness (87.5%), pain (66.7%), and blurring of vision (17.8%). Decreased visual acuity was most common in necrotizing scleritis (50.0%), and posterior scleritis (38.5%) (p = 0.097). Autoimmune and infective causes were associated with 33.3% and 8.3% of scleritis patients respectively. The most common associated autoimmune cause was Rheumatoid Arthritis (35.0%), followed by Wegener’s Granulomatosis (12.5%). Ocular complications included anterior uveitis (42.5%), peripheral keratitis (11.7%), and glaucoma (15.0%). 50.4% of patients were treated with oral corticosteroids while 21.3% were treated with immunosuppressants. Recurrence occurred in 16.7% of patients. The median follow up period was 56 weeks (IQR: 12-247 weeks).
Scleritis is a severe ocular inflammation, often associated with ocular complications. The main complications include uveitis, corneal involvement and glaucoma, especially for patients with necrotizing scleritis and posterior scleritis. A significant proportion of our patients required systemic corticosteroids or immunosuppressives to control the condition. Close monitoring, systemic evaluation and timely treatment are necessary for these patients.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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