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