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Louisa P. Thong, Sophie Rogers, Colby Hart, Anthony John Hall, Lyndell L Lim; Incidence and Prevalence of Episcleritis and Scleritis in Metropolitan Melbourne. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4168.
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Population-based studies of episcleritis and scleritis are limited. The aim of this retrospective study was to determine the incidence and prevalence of episcleritis and scleritis in a well-defined population of Metropolitan Melbourne and describe their clinical characteristics.
All patients with episcleritis or scleritis seen at the Emergency Department or the Ocular Immunology Clinic of The Royal Victorian Eye and Ear Hospital were identified from November 2014 through to October 2015. Medical records were retrospectively reviewed to confirm diagnosis, establish time of onset, and collect aetiology and ocular complications. Age and gender-stratified population data from the Australian Bureau of Statistics 2015 were used to calculate incidence and prevalence.
The adult population of the Metropolitan Melbourne catchment was 3,500,331 people. During the 1-year period, there were 147 new-onset and 23 prior-onset cases of active episcleritis, and 34 new-onset and 20 prior-onset cases of active scleritis. For episcleritis, this yielded an incidence of 4.2/100,000 person-years and a 12-month period prevalence of 4.9/100,000 persons. Females aged 25-44 years had a higher incidence (p=0.03) and prevalence (p=0.02) of episcleritis. For scleritis, the incidence was 1.0/100,000 person-years and the 12-month period prevalence was 1.5/100,000 persons. There was increased scleritis in females aged 45-64 years for both incident (p=0.04) and prevalent (p=0.05) cases. Most cases of episcleritis were simple (84%) with the remaining being nodular. For scleritis, there was 1 infectious case. Of those with non-infectious scleritis, diffuse scleritis was the most common (62%), followed by nodular (27%) and posterior scleritis (11%). Systemic disease was associated with 33% of scleritis patients compared to 10% of episcleritis (p<0.001). In particular, rheumatoid arthritis was found in 19% of scleritis patients but in only 2% of episcleritis. Ocular complications were seen in 3% of episcleritis eyes versus 46% of scleritis eyes (p<0.001).
In this first Australian study, population rates of episcleritis and scleritis were lower compared to previous U.S. studies and more commonly affected young to middle-aged females. Clinical characteristics of this population confirmed that episcleritis often remained benign, whereas scleritis was more severe in nature.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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