Abstract
Purpose: :
To analyze clinical features, systemic associations, treatment in patients with scleritis.
Methods: :
Clinical records of 99 patients with scleritis who presented between April 2004 and September 2011 to the Ophthalmology at Nippon Medical School, Tokyo, were reviewed retrospectively.
Results: :
Of the 99 patients, 57.6% had diffuse anterior scleritis, 20% had episcleritis, 16% had nodular anterior scleritis, 4% had necrotizing anterior scleritis, and 2% had posterior scleritis. Mean age at presentation was 53.5±15.2 (range 22-83 years). Secondary ocular complications were observed in 32% of patients, including anterior uveitis in 9%, increased intraocular pressure 31%. Systemic disease association was seen in 20% patients, including rheumatoid arthritis, tuberculosis, relapsing polychondritis, Wegener’s granulomatosis, seronegative arthritis, and so on.100% of episcleritis and 87.7% of diffuse anterior scleritis were treated with only topical application of steroids and/or immunosuppressive drugs. 6.3% of nodular anterior scleritis, 75% of necrotizing anterior scleritis, and 100% of posterior scleritis needed systemic treatments with oral corticosteroids and/or immunosuppressive drugs. 15.2% of scleritis without systemic disease were treated with oral corticosteroids and/or immunosuppressive drugs, biologic agent (anti-TNF agent). On the other hand, 30% of scleritis associated with systemic disease needed systemic medication.
Conclusions: :
About 90% of diffuse anterior scleritis and nodular anterior scleritis were treated with only topical application of steroids and/or immunosuppressive drugs. On the other hand, most of necrotizing anterior scleritis and posterior scleritis received oral corticosteroids and/or immunosuppressive drugs, biologic agent. Our report suggested that scleritis associated with a systemic disease needs oral corticosteroids and/or immunosuppressive drugs, biologic agent (anti-TNF) more often than scleritis without systemic disease.
Keywords: autoimmune disease • sclera • clinical (human) or epidemiologic studies: outcomes/complications