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Kazuhisa Takahashi, Kuniko Wakayama, Hiroshi Takahashi, Junko Hori; Clinical Features and Treatment Outcome of Japanese Patients with Scleritis. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1255.
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To analyze clinical features, systemic associations, treatment in patients with scleritis.
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.
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.
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.
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