A clinical case of recurrent episcleritis as the initial manifestation of granulomatosis with polyangiitis

Ciotoracu, Andra Carmina; Dimăncescu, Monica Gabriela; Mitulescu, Traian Costin; Haralambie, Claudia Iuliana; Iorga, Ana-Maria; Busuioc, Constantin; Predeţeanu, Denisa

doi:10.22336/rjo.2021.76

Cited by 4 publications

(2 citation statements)

References 12 publications

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“…steroid-sparing treatments are a viable and safe alternative to corticosteroids in treating episcleritis, although symptoms can recur despite treatment [6,7]. We found that combined oral and topical NSAID treatment regimens were safe and effective for the management of non-infectious treatment-naive unilateral episcleritis.…”

Section: Discussionmentioning

confidence: 91%

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Add-on therapy with different non-steroidal anti-inflammatory agents in the management of non-infectious, non-necrotizing episcleritis

Özer¹,

Tuncer²

2022

Med Hypothesis Discov Innov Optom

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Background: Episcleritis is a common ocular inflammatory disease that can cause red eye. It is usually managed using single or combined topical corticosteroids and topical or oral non-steroidal anti-inflammatory drugs (NSAIDs) as directed by clinical response. However, recurrence is possible. This study aimed to compare the effects of add-on therapies using different topical NSAIDs in the management of treatment-naive, non-infectious, non-necrotizing episcleritis. Methods: Seventy-five eyes of 75 patients with non-infectious, non-necrotizing unilateral episcleritis were included in this study. Patients were allocated to one of three groups based on the NSAID used as add-on therapy: topical diclofenac sodium 0.1% (group D), topical nepafenac 0.1% (group N1), and topical nepafenac 0.3% (group N3). The time to symptom disappearance was defined as the recovery time. Results: There were no statistically significant differences in age, sex, initial best-corrected distance visual acuity, and intraocular pressure between groups (all P > 0.05). The mean recovery times of groups D and N1 were comparable (12.86 ± 5.35 days and 11.45 ± 5.42 days, respectively) (P > 0.05). However, the mean recovery time of group N3 was significantly shorter (9.70 ± 3.80 days, P < 0.05). Recurrence was observed in only one patient in group N1 at 3 months, and symptoms resolved when the same medication was reinstituted. Furthermore, we noted no side effects during the follow-up period for any of the treatment modalities. Conclusions: All three topical NSAIDs were effective add-on therapies in the management of non-infectious, non-necrotizing unilateral episcleritis. However, once-daily administration of topical nepafenac 0.3% had a shorter recovery time than topical diclofenac 0.1% and topical nepafenac 0.1%.

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Section: Discussionmentioning

confidence: 91%

“…Episcleritis is usually managed using single or combined topical corticosteroids or topical or oral non-steroidal anti-inflammatory drugs (NSAIDs), as determined by clinical response [1]. However, recurrence is possible [6,7].…”

Section: Introductionmentioning

confidence: 99%

Add-on therapy with different non-steroidal anti-inflammatory agents in the management of non-infectious, non-necrotizing episcleritis

Özer¹,

Tuncer²

2022

Med Hypothesis Discov Innov Optom

View full text Add to dashboard Cite

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An atypical presentation of granulomatosis with polyangiitis: A case report

Maqbool¹,

Maqbool²,

Maqbool³

et al. 2023

Radiology Case Reports

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A Case of an Elderly Woman Who Developed Corneal Perforation in the Clinical Course of Myeloperoxidase Positive Antineutrophil Cytoplasmic Antibody-Associated Vasculitis

Kobayashi,

Harada,

Yamada

et al. 2023

Case Reports in Rheumatology

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Antineutrophil cytoplasmic antibody- (ANCA-) associated vasculitis (AAV) is a systemic vasculitis characterized by ANCA positivity and categorized into three main types: microscopic polyangiitis, granulomatosis with polyangiitis, and eosinophilic granulomatous with polyangiitis. Although AAV leads to systemic organ injury, such as of the lungs, kidneys, nerves, and skin, patients with AAV sometimes develop ocular lesions. Here, we report the case of an elderly woman who had been treated for AAV for seven years. She developed scleritis and relapsed twice, with elevation of serum disease markers such as ANCA titer and C-reactive protein. After the decline of these markers due to treatment with additional medication, her scleritis relapsed again and caused a corneal ulcer, which resulted in perforation without obvious marker elevation. She did not present with any symptoms of organ injury, except for ocular lesions. She was treated with surgery, followed by methylprednisolone and rituximab therapy. Subsequently, her ocular lesions and symptoms improved, and she did not relapse. AAV can cause various ocular manifestations. Although C-reactive protein and ANCA titers are useful markers of disease activity and the relapse of AAV complications, including ocular lesions, these markers do not always increase at the time of worsening ocular lesions. Therefore, it is important for clinicians treating patients with AAV to pay careful attention to serum data and physical findings, including the eyes.

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A clinical case of recurrent episcleritis as the initial manifestation of granulomatosis with polyangiitis

Cited by 4 publications

References 12 publications

Add-on therapy with different non-steroidal anti-inflammatory agents in the management of non-infectious, non-necrotizing episcleritis

Add-on therapy with different non-steroidal anti-inflammatory agents in the management of non-infectious, non-necrotizing episcleritis

An atypical presentation of granulomatosis with polyangiitis: A case report

A Case of an Elderly Woman Who Developed Corneal Perforation in the Clinical Course of Myeloperoxidase Positive Antineutrophil Cytoplasmic Antibody-Associated Vasculitis

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