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E. Y. Oregon Miranda, A. Lorenzo Mejia, J. Carmona Hernandez, G. Lazcano Gomez, F. Barrera Pelayo, P. Navarro Lopez, L. Arellanes Garcia; Clinical Features, Diagnosis and Evolution of Scleritis inaA Mexican-Mestizo Population. Invest. Ophthalmol. Vis. Sci. 2008;49(13):810.
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To show the frequency of scleritis in a population of Mexican patients as the initial manifestation of systemic diseases, and to describe by subtype the associated diseases, clinical features, treatment and complications.
Retrospective, descriptive, observational trial. We reviewed 6854 patients admitted to the inflammatory eye disease clinic of an ophthalmic hospital located in Mexico city, during the last 18 years. There were found 400 cases with scleritis, 129 files were complete and with a minimal follow up of 3 months. We recorded the subtype, associated illness, initial and final visual acuity, average initial and final IOP, intraocular inflammation, treatment, associated ophthalmic pathologies, time otorecurrence, complications, evolution and time elapsed for recovery by treatment.
the prevalence of scleritis was 5.9%. 23 of the 129 patients were bilateral. It is more frequently presented in women average 45 years old. The most frequent associated non- infectious disease was rheumatoid arthritis and herpes on the infectious type. The most prevalent subtype was anterior diffuse. The complications depended upon the subtype, in the necrosis type: ocular perforation, on the nodular and diffuse subtype it was cataract and high intraocular pressure. Dry eye and ulcerative keratitis were more frequently associated with rheumatoid arthritis. Only one third of our patients showed intraocular inflammation with cels +. We found a tendency towards the failure of treatment when only one medication was used (either oral or topic steroids, or topical or oral AINES) .Most of our patients were discovered to have a general illness after their notessed ocular symptoms.
Scleritis are infrequent even in a referral institution. The systemic disease most commonly associated was rheumatoid arthritis, which also had added ophthalmic pathologies: dry eye and ulcerative keratitis. The necrosis type has a poorer prognosis because it is associated with a high risk of ocular perforation. The first sign of systemic disease is scleritis in 89% of our patients probably because of the low income and poor education of our population. Failure of treatment is probably related to the use of unique therapies either topical or oral. We found success with the use of oral steroids combined with topical AINES for anterior scleritis type (diffuse or nodular) on 45% of our patients.
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