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Tomoyuki Kunishige, Kohei Miyata, Satoko Yui, Kenji Nakamoto, Junko Hori; Clinical statistics for secondary glaucoma in patients with scleritis. Invest. Ophthalmol. Vis. Sci. 2017;58(8):552.
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© ARVO (1962-2015); The Authors (2016-present)
We have previously reported clinical statistics for secondary glaucoma in ocular inflammatory diseases including sarcoidosis and Behcet’s disease. The purpose of the present study is to provide a clinical statistical study of secondary glaucoma in patients with scleritis at the Ocular Inflammation Service, Nippon Medical School Hospital.
This retrospective study was based on a review of medical records. Among patients with a defined diagnosis of scleritis (n=203) who were evaluated as outpatients in the Ocular Inflammation Service, Department of Ophthalmology at Nippon Medical School Hospital between April 2004 and May 2016, and who also developed secondary glaucoma (n= 59). This study comprised 59 patients, 83 eyes (36 men, 52 eyes; 23 women, 31 eyes) in whom tonometry and Humphrey visual field testing with measurement of mean deviation (MD) had been performed at least twice.
29％ (59 out of 203) scleritis patients developed secondary glaucoma. Among them, steroid-induced glaucoma was diagnosed in 81%. Causative scleritis associated with secondary glaucoma included episcleritis in 16%, diffuse anterior scleritis in 60%, nodular anterior scleritis in 18%, necrotizing anterior scleritis in 4%, and posterior scleritis in 1% of cases. At initial evaluation in scleritis patients with secondary glaucoma, mean intraocular pressure was 19.1 ± 6.1 mmHg and MD was -2.0 ± 4.0 dB. At final evaluation, mean intraocular pressure was 15.5 ± 4.2 mmHg and MD was -2.6 ± 4.6 dB (Mean follow-up period 29.6 ± 32.6 months). In compare with our previous studies for sarcoidosis (-7.26 ± 7.80dB at initial evaluation, -8.86 ± 9.68dB at final evaluation) and Behcet’s disease (-7.64 ± 5.99dB at initial evaluation, -10.5 ± 7.98dB at final evaluation), scleritis was less progressive visual field defect. Glaucoma surgery was performed in 5 eyes of scleritis patients, and the procedure involved trabeculectomy in 2 eyes and trabeculotomy in 3 eyes.
Scleritis was frequent in eyes that developed steroid-induced glaucoma. Careful selection of treatment and management of intraocular pressure is important in scleritis.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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