Korean J Ophthalmol.  2010 Dec;24(6):331-335. 10.3341/kjo.2010.24.6.331.

Clinical Features, Predisposing Factors, and Treatment Outcomes of Scleritis in the Korean Population

• Ahn SJ
• Oh JY
• Kim MK
• Lee JH
• Wee WR

• KMID: 1769085
• DOI: http://doi.org/10.3341/kjo.2010.24.6.331

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.

Keyword

Clinical feature; Pterygium excision; Scleritis; Treatment outcome

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
*Asian Continental Ancestry Group
Bacterial Infections
Child
Eyeglasses
Female
Humans
Male
Medical Records
Middle Aged
Mycoses
Postoperative Period
Pterygium/surgery
Retrospective Studies
Scleritis/classification/ethnology/*etiology/*surgery
Treatment Outcome
Visual Acuity
Young Adult

Figure

• 

  Fig. 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.

• 

  Fig. 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).

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