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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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Survival curves of remission. A significant difference in remission was observed (p=0.028) among the different scleritis subtypes. No significant difference was seen between infectious versus noninfectious, and seropositive versus seronegative cases. The y-axis indicates the proportion of cases with persistent scleritis as calculated by the following equation: (1 - the proportion of remission).
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Figure 2: Survival curves of remission. A significant difference in remission was observed (p=0.028) among the different scleritis subtypes. No significant difference was seen between infectious versus noninfectious, and seropositive versus seronegative cases. The y-axis indicates the proportion of cases with persistent scleritis as calculated by the following equation: (1 - the proportion of remission).

Mentions: The median time to resolution was significantly longer in necrotizing scleritis (10 months, p = 0.028; log rank test), compared to diffuse (7 months) and nodular subtypes (7 months) (Fig. 2). The median time to resolution of infectious scleritis was longer than non-infectious type (10 months vs. 8 months); however, this difference was not statistically significant (p = 0.166). There was no difference in the median time to resolution between seropositive and seronegative scleritis (p = 0.732).


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)

Survival curves of remission. A significant difference in remission was observed (p=0.028) among the different scleritis subtypes. No significant difference was seen between infectious versus noninfectious, and seropositive versus seronegative cases. The y-axis indicates the proportion of cases with persistent scleritis as calculated by the following equation: (1 - the proportion of remission).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Survival curves of remission. A significant difference in remission was observed (p=0.028) among the different scleritis subtypes. No significant difference was seen between infectious versus noninfectious, and seropositive versus seronegative cases. The y-axis indicates the proportion of cases with persistent scleritis as calculated by the following equation: (1 - the proportion of remission).
Mentions: The median time to resolution was significantly longer in necrotizing scleritis (10 months, p = 0.028; log rank test), compared to diffuse (7 months) and nodular subtypes (7 months) (Fig. 2). The median time to resolution of infectious scleritis was longer than non-infectious type (10 months vs. 8 months); however, this difference was not statistically significant (p = 0.166). There was no difference in the median time to resolution between seropositive and seronegative scleritis (p = 0.732).

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