Abstract
Purpose :
We performed a retrospective, observational clinical study to identify differences in treatment utilization for acute scleritis across medical specialties.
Methods :
The records of 256 patients (302 eyes) with scleritis who presented to the Yale New Haven Health System between January 1, 2013 to January 1, 2018 were retrospectively reviewed. Data was collected on treatments utilized and the specialty of the provider caring for the patient. The primary outcome was quiescence of inflammation at three months. The study was approved by the Institutional Review Board (IRB).
Results :
We identified 256 patients (302 eyes), including 232 patients (90.6%) with diffuse anterior scleritis, 10 (3.9%) with nodular anterior scleritis, 5 (2%) with necrotizing scleritis, and 9 (3.5%) with posterior scleritis. 173 patients (67.2%) had an ophthalmologist involved in their care, 19 (4.6%) were managed by their rheumatologist alone, 16 (6.3%) were managed by their primary care physician, and 15 (5.9%) were managed by an emergency medicine physician. Patients seen by ophthalmologists were overall more likely to receive acute treatment than those not seen by ophthalmologists (91.9% compared to 50.6%, p<0.05). Patients seen by an ophthalmologist were more likely to receive topical steroids (61.3% compared to 10.8%, p<0.05), systemic non-steroidal anti-inflammatory drugs (NSAIDs) (43.4% compared to 14.5%, p<0.05), or systemic steroids (38.7% compared to 24.1%, p<0.05). Patients seen by an ophthalmologist were more likely to resolve within three months (49.5% compared to 10.0%, p<0.05). All patients with necrotizing or posterior scleritis were seen and managed by an ophthalmologist, as were the majority of those with systemic disease (61.1%).
Conclusions :
There were differences in medication utilization among specialty types, and patients with an ophthalmologist involved with their care were more likely to have resolution of symptoms. Patients with scleritis may benefit from ophthalmologic consultation.
This is a 2021 ARVO Annual Meeting abstract.