June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Infectious Scleritis: A 30 years Retrospective Study
Author Affiliations & Notes
  • Guillermo Andrés Requejo
    Universidad de Puerto Rico Recinto de Ciencias Medicas, San Juan, Puerto Rico
  • Alejandra Santiago
    Universidad de Puerto Rico Recinto de Ciencias Medicas, San Juan, Puerto Rico
  • Esteban Vázquez Valencia
    Ophthalmology, Universidad de Puerto Rico Recinto de Ciencias Medicas, San Juan, Puerto Rico
  • Emilio Báez Rivera
    Ophthalmology, Universidad de Puerto Rico Recinto de Ciencias Medicas, San Juan, Puerto Rico
  • Lilia Rivera Román
    Ophthalmology, Universidad de Puerto Rico Recinto de Ciencias Medicas, San Juan, Puerto Rico
  • Armando Oliver
    Ophthalmology, Universidad de Puerto Rico Recinto de Ciencias Medicas, San Juan, Puerto Rico
  • Carmen Santos
    Ophthalmology, Universidad de Puerto Rico Recinto de Ciencias Medicas, San Juan, Puerto Rico
  • Footnotes
    Commercial Relationships   Guillermo Requejo None; Alejandra Santiago None; Esteban Vázquez Valencia None; Emilio Báez Rivera None; Lilia Rivera Román None; Armando Oliver None; Carmen Santos None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 3558 – A0445. doi:
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      Guillermo Andrés Requejo, Alejandra Santiago, Esteban Vázquez Valencia, Emilio Báez Rivera, Lilia Rivera Román, Armando Oliver, Carmen Santos; Infectious Scleritis: A 30 years Retrospective Study. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3558 – A0445.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Infectious scleritis is a rare disease with few large series reports in the literature and an etiology that varies based on geographic region and different climates. In addition, knowledge of disease epidemiology and predisposing factors is scarce. Since there is no previous study describing this ocular infection in Puerto Rico, we decided to determine the etiology of infectious scleritis, predisposing factors, complications, treatment strategies, and final disease outcomes in a cohort of patients living in Puerto Rico.

Methods : A retrospective chart review of infectious scleritis cases, dating from 1988 to 2018, of three cornea specialist practices in Puerto Rico. Both culture-proven, as well as cultures-negative cases, were included in the study. Demographic characteristics were recorded. In addition, the following information was gathered from each patient chart: inciting event, time from predisposing event to disease development, time of infection onset to cornea specialist evaluation, cultures results, involved organism (for positive culture cases), presenting signs and symptoms, visual acuity upon presentation, final visual acuity outcome, photographic documentation, treatment strategy, complications, and final disease outcome.

Results : Forty-five patients who met the research criteria for a diagnosis of infectious scleritis were identified and included in the analysis. The most common ocular sign was hyperemia (87%) and the most frequent symptom was pain (87%). Visual acuity at presentation was worse than 20/200 in 36% of eyes. The median duration of therapy was 112 days. Surgical intervention was performed on 17% of eyes which consisted of debridement (4%), tenoplasty and amniotic membrane graft (4%), corneal/scleral patch graft (2%), removal of a hardware device (6.7%, 3 scleral buckles), and pars plana vitrectomy (2%). Final visual acuity was 20/200 or better in 69% of eyes. 100% of the patients were able to save their eye from infection and 69% maintained useful vision.

Conclusions : Our findings are consistent with previous reports. Pterygium surgery was the most common surgical intervention associated with the subsequent development of infectious scleritis, followed by glaucoma surgery. Pseudomonas aeruginosa is the most common bacteria involved in the widespread use of adjunctive therapies, like mitomycin C, in these two ophthalmic procedures, which may explain the high incidence of infectious scleritis after these surgeries.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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