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Clinical features, predisposing factors, and treatment outcomes of scleritis in the Korean population.

Ahn SJ, Oh JY, Kim MK, Lee JH, Wee WR - Korean J Ophthalmol (2010)

Bottom Line: A total of 16 of 76 patients (21.1%) had connective tissue diseases.Systemic immunosuppression was required in addition to steroids for treating diffuse and necrotizing scleritis.In addition, evaluation of microbiological infection can be crucial for patients with necrotizing scleritis and history of pterygium excision.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To evaluate the clinical features, associated factors, and treatment outcomes of scleritis in the Korean population.

Methods: Medical records were retrospectively reviewed for 94 eyes of 76 patients with scleritis. Clinical features of scleritis, including systemic disease, presence of microorganisms, serologic markers, history of previous ocular surgery, and use of immunosuppressants were investigated and compared amongst the subtypes of scleritis. Treatment outcomes were evaluated using best corrected visual acuity (BCVA) and time to scleritis remission.

Results: Nodular scleritis was the most common form observed, followed by necrotizing scleritis with inflammation, diffuse scleritis, and necrotizing scleritis without inflammation, respectively. A total of 16 of 76 patients (21.1%) had connective tissue diseases. Eleven cases (14.5%) had infectious scleritis, of which bacteria (54.5%) and fungi (45.5%) were the causative microorganisms. Thirty-three patients (43.4%) had previous ocular surgery, mostly pterygium excision. Notably, a history of pterygium excision was significantly associated with development of necrotizing and infectious scleritis (odds ratio [OR], 399 and 10.1; p < 0.001 and 0.002, respectively). In addition, patients with necrotizing scleritis were more likely to have infectious scleritis (OR, 11.7; p = 0.001). BCVA after treatment and time to remission also showed significant differences among the different scleritis subtypes. Systemic immunosuppression was required in addition to steroids for treating diffuse and necrotizing scleritis.

Conclusions: Careful taking of patient history including previous pterygium excision should be performed, especially in patients with necrotizing and infectious scleritis. In addition, evaluation of microbiological infection can be crucial for patients with necrotizing scleritis and history of pterygium excision.

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Visual acuities before and after treatment. Patients with infectious necrotizing scleritis had the poorest best corrected visual acuities (BCVA) before and after treatment. The data are presented as the mean±standard deviation. logMAR = logarithmic value of the minimal angle of resolution.
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Figure 1: Visual acuities before and after treatment. Patients with infectious necrotizing scleritis had the poorest best corrected visual acuities (BCVA) before and after treatment. The data are presented as the mean±standard deviation. logMAR = logarithmic value of the minimal angle of resolution.

Mentions: To evaluate visual outcome according to subtypes of scleritis, BCVA was investigated at the time of diagnosis and after remission (Fig. 1). BCVA at the time of diagnosis was worse in patients with infectious and necrotizing scleritis than patients with nodular and diffuse scleritis. Patients with infectious scleritis had the worst BCVA after remission (1.19 ± 1.11), followed by non-infectious necrotizing (0.538 ± 0.457), nodular (0.367 ± 0.637), and diffuse scleritis (0.282 ± 0.506). These differences in visual acuities among subtypes of scleritis were statistically significant (p = 0.013 at the time of diagnosis and 0.008 after remission; one-way ANOVA).


Clinical features, predisposing factors, and treatment outcomes of scleritis in the Korean population.

Ahn SJ, Oh JY, Kim MK, Lee JH, Wee WR - Korean J Ophthalmol (2010)

Visual acuities before and after treatment. Patients with infectious necrotizing scleritis had the poorest best corrected visual acuities (BCVA) before and after treatment. The data are presented as the mean±standard deviation. logMAR = logarithmic value of the minimal angle of resolution.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2992559&req=5

Figure 1: Visual acuities before and after treatment. Patients with infectious necrotizing scleritis had the poorest best corrected visual acuities (BCVA) before and after treatment. The data are presented as the mean±standard deviation. logMAR = logarithmic value of the minimal angle of resolution.
Mentions: To evaluate visual outcome according to subtypes of scleritis, BCVA was investigated at the time of diagnosis and after remission (Fig. 1). BCVA at the time of diagnosis was worse in patients with infectious and necrotizing scleritis than patients with nodular and diffuse scleritis. Patients with infectious scleritis had the worst BCVA after remission (1.19 ± 1.11), followed by non-infectious necrotizing (0.538 ± 0.457), nodular (0.367 ± 0.637), and diffuse scleritis (0.282 ± 0.506). These differences in visual acuities among subtypes of scleritis were statistically significant (p = 0.013 at the time of diagnosis and 0.008 after remission; one-way ANOVA).

Bottom Line: A total of 16 of 76 patients (21.1%) had connective tissue diseases.Systemic immunosuppression was required in addition to steroids for treating diffuse and necrotizing scleritis.In addition, evaluation of microbiological infection can be crucial for patients with necrotizing scleritis and history of pterygium excision.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To evaluate the clinical features, associated factors, and treatment outcomes of scleritis in the Korean population.

Methods: Medical records were retrospectively reviewed for 94 eyes of 76 patients with scleritis. Clinical features of scleritis, including systemic disease, presence of microorganisms, serologic markers, history of previous ocular surgery, and use of immunosuppressants were investigated and compared amongst the subtypes of scleritis. Treatment outcomes were evaluated using best corrected visual acuity (BCVA) and time to scleritis remission.

Results: Nodular scleritis was the most common form observed, followed by necrotizing scleritis with inflammation, diffuse scleritis, and necrotizing scleritis without inflammation, respectively. A total of 16 of 76 patients (21.1%) had connective tissue diseases. Eleven cases (14.5%) had infectious scleritis, of which bacteria (54.5%) and fungi (45.5%) were the causative microorganisms. Thirty-three patients (43.4%) had previous ocular surgery, mostly pterygium excision. Notably, a history of pterygium excision was significantly associated with development of necrotizing and infectious scleritis (odds ratio [OR], 399 and 10.1; p < 0.001 and 0.002, respectively). In addition, patients with necrotizing scleritis were more likely to have infectious scleritis (OR, 11.7; p = 0.001). BCVA after treatment and time to remission also showed significant differences among the different scleritis subtypes. Systemic immunosuppression was required in addition to steroids for treating diffuse and necrotizing scleritis.

Conclusions: Careful taking of patient history including previous pterygium excision should be performed, especially in patients with necrotizing and infectious scleritis. In addition, evaluation of microbiological infection can be crucial for patients with necrotizing scleritis and history of pterygium excision.

Show MeSH
Related in: MedlinePlus