Abstract
Purpose :
Scleritis is a rare disease with the potential for severe complications and vision loss. Scleritis is more common in adults but also affects children and young adults. Our study evaluates features of pediatric scleritis in the IRIS Registry® (Intelligent Research in Sight) and compares these features in pediatric, young adult, and adult scleritis cohorts.
Methods :
We completed a retrospective database study of IRIS Registry patients with a scleritis diagnostic code at ≥3 office visits during 2013-2019. Patients were divided into three age cohorts: pediatric (<18 years, N=1,825), young adult (18-21 years, N=1,081) and adult (>21 years, N=108,380). We compared demographic and clinical features in these cohorts, using chi-square testing for statistical analysis.
Results :
Male sex was more common in pediatric scleritis patients (53%) than in young adult (38%) and adult (33%) scleritis patients (p<0.001). Although the majority of scleritis patients in all age cohorts were white, non-white race-ethnicity was more common in pediatric scleritis patients (27%) than in young adult (22%) and adult scleritis patients (21%) (p<0.001). Cataract, pseudophakia, or aphakia was less common in pediatric and young adult than adult scleritis patients (7% and 7% vs 61%, p<0.001), as was glaucoma (5% and 4% vs 15%, p<0.001). Although ocular hypertension as defined by an intraocular pressure measurement of ≥ 30 mmHg was less frequent in pediatric scleritis eyes (6%) than adult eyes (8%), this difference was not significant (p=0.06). Average visual acuity at presentation was good in all age groups: Mean±SD best-corrected visual acuity at first scleritis visit in logMAR units was 0.12±0.30 in pediatric patients, 0.13±0.34 in young adult patients, and 0.20±0.38 in adult patients. Adult patients were more likely to have vision loss equivalent to ≥3 Snellen lines 6±2 months from initial presentation compared with pediatric patients (5% vs 2%, p=0.008).
Conclusions :
This IRIS Registry study found age-related differences in demographic and clinical features of scleritis patients. Cataract, glaucoma, and vision loss were relatively infrequent in pediatric scleritis patients but are serious complications with potential for long-term ocular morbidity. This work highlights the importance of further study in pediatric scleritis patients to evaluate risk factors for ocular complications.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.