September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Clinical characteristics of Japanese patients with scleritis
Author Affiliations & Notes
  • Rie Tanaka
    Ophthalmology, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
  • Kazuyoshi Ohtomo
    Ophthalmology, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
  • Mitsuko Takamoto
    Ophthalmology, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
  • Keiko Komae
    Ophthalmology, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
  • Jiro Numaga
    Ophthalmology, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
  • Yujiro Fujino
    Ophthalmology, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
  • Makoto Aihara
    Ophthalmology, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
  • Toshikatsu Kaburaki
    Ophthalmology, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
  • Footnotes
    Commercial Relationships   Rie Tanaka, None; Kazuyoshi Ohtomo, None; Mitsuko Takamoto, None; Keiko Komae, None; Jiro Numaga, None; Yujiro Fujino, None; Makoto Aihara, None; Toshikatsu Kaburaki, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 4129. doi:
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      Rie Tanaka, Kazuyoshi Ohtomo, Mitsuko Takamoto, Keiko Komae, Jiro Numaga, Yujiro Fujino, Makoto Aihara, Toshikatsu Kaburaki; Clinical characteristics of Japanese patients with scleritis. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4129.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To investigate the clinical features, underlying etiology, secondary ocular complications, and treatment in Japanese patients with scleritis.

Methods : The clinical records of 111 patients with scleritis who presented to the uveitis clinic of The University of Tokyo Hospital between January 2004 and February 2015 were retrospectively reviewed.

Results : The cohort comprised 51 males and 60 females (57.6±16.4 years). Forty-four patients (40%) had bilateral scleritis. Of the 111 patients, 68 (61%) showed diffuse anterior scleritis, 16 (14%) showed nodular anterior scleritis, 9 (8%) showed necrotizing anterior scleritis, and 18 (16%) showed posterior scleritis. Sixty-one patients (55%) had an episode of recurrence, and there were no statistically significant differences among the 4 types of scleritis. Further investigations revealed an underlying etiology in 39 patients (35%), including 8 with rheumatoid arthritis, 7 with antineutrophil cytoplasmic antibody-associated vasculitis, 6 with relapsing polychondritis, 4 with herpes virus infection, 2 with psoriasis, 2 with tuberculosis, and 2 with Behçet’s disease.
Secondary ocular complications were observed in 72% of the patients, including anterior uveitis in 43 (39%), increased intraocular pressure in 43 (39%), scleral thinning in 30 (27%), peripheral ulcerative keratitis in 30 (27%), serous retinal detachment in 9 (8%), anterior staphyloma in 9 (8%), cystoid macular edema in 8 (7%), and hyperemic disc in 7 (6%).
Forty-nine patients (44%) received a systemic corticosteroid and 19 (17%) received other immunosuppressive agents as follows: 13 patients were treated with methotrexate, 5 were treated with pulsed intravenous cyclophosphamide, and 4 were treated with biologics. All 5 patients who received pulsed intravenous cyclophosphamide achieved remission of ocular inflammation.

Conclusions : The underlying etiology was identified in 35% of the patients with scleritis. A careful observation must be conducted as approximately 40% of patients with scleritis had increased intraocular pressure. Immunosuppressive agents may serve as a treatment option in severe cases.

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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