Clinical Features of Scleritis Across the Asia-Pacific Region

Lane, Joshua E.; Nyugen, Ethan; Morrison, Julie; Stawell, Richard; Hodgson, Lauren; Ismail, Muhammad Amir Bin; Ling, Ho Su; Teoh, Stephen C.; Agrawal, Rupesh; Mahendradas, Padmamalini; Hari, Parvathi; Gowda, Poornachandra B; Kawali, Ankush; McCluskey, Peter

doi:10.1080/09273948.2018.1484496

Cited by 28 publications

(25 citation statements)

References 20 publications

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“…Epidemiologic research in different world regions reveals different patterns (Supplementary Table 1, available on | 1275 the Arthritis & Rheumatology website at http://onlin elibr ary.wiley. com/doi/10.1002/art.41709/ abstract), with more infectious causes in India, for example (26). The systemic associations highlight the potential value of cross-specialty multidisciplinary care to detect preclinical or early disease and optimize management (27).…”

Section: Discussionmentioning

confidence: 99%

“…We identified significant associations with 19 I‐IMIDs, with the strongest associations observed with both preexisting and subsequent diagnoses of GPA (OR 50.7 and HR 96.4, P < 0.001 for both), BD (OR 9.1, P = 0.014; HR 17.5, P = 0.011), SS (OR 7.1 and HR 8.5, P < 0.001 for both), RA (OR 5.7 and HR 4.2, P < 0.001 for both), other vasculitis (OR 5.4 and HR 6.7, P < 0.001 for both), Crohn’s disease (OR 3.6 and HR 4.2, P < 0.001 for both), SLE (OR 3.5 and HR 8.5, P < 0.001 for both), GCA (OR 3.8, P = 0.001; HR 2.4, P = 0.043), AS (OR 3.4, P < 0.001; HR 3.4, P = 0.020), and sarcoidosis (OR 2.6, P < 0.001; HR 3.1, P = 0.025). Epidemiologic research in different world regions reveals different patterns (Supplementary Table 1, available on the Arthritis & Rheumatology website at http://onlinelibrary.wiley.com/doi/10.1002/art.41709/abstract), with more infectious causes in India, for example (26). The systemic associations highlight the potential value of cross‐specialty multidisciplinary care to detect preclinical or early disease and optimize management (27).…”

Section: Discussionmentioning

confidence: 99%

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Epidemiology of Scleritis in the United Kingdom From 1997 to 2018: Population‐Based Analysis of 11 Million Patients and Association Between Scleritis and Infectious and Immune‐Mediated Inflammatory Disease

Braithwaite

Adderley

Subramanian

et al. 2021

Arthritis & Rheumatology

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Objective To estimate 22‐year trends in the prevalence and incidence of scleritis, and the associations of scleritis with infectious and immune‐mediated inflammatory diseases (I‐IMIDs) in the UK. Methods The retrospective cross‐sectional and population cohort study (1997–2018) included 10,939,823 patients (2,946 incident scleritis cases) in The Health Improvement Network, a nationally representative primary care records database. The case–control and matched cohort study (1995–2019) included 3,005 incident scleritis cases and 12,020 control patients matched by age, sex, region, and Townsend deprivation index. Data were analyzed using multivariable Poisson regression, multivariable logistic regression, and Cox proportional hazards multivariable models adjusted for age, sex, Townsend deprivation index, race/ethnicity, smoking status, nation within the UK, and body mass index. Incidence rate ratios (IRRs) and 95% confidence intervals (95% CIs) were calculated. Results Scleritis incidence rates per 100,000 person‐years declined from 4.23 (95% CI 2.16–6.31) to 2.79 (95% CI 2.19–3.39) between 1997 and 2018. The prevalence of scleritis per 100,000 person‐years was 93.62 (95% CI 90.17–97.07) in 2018 (61,650 UK patients). Among 2,946 patients with incident scleritis, 1,831 (62.2%) were female, the mean ± SD age was 44.9 ± 17.6 years (range 1–93), and 1,257 (88.8%) were White. Higher risk of incident scleritis was associated with female sex (adjusted IRR 1.53 [95% CI 1.43–1.66], P < 0.001), Black race/ethnicity (adjusted IRR 1.52 [95% CI 1.14–2.01], P = 0.004 compared to White race/ethnicity), or South Asian race/ethnicity (adjusted IRR 1.50 [95% CI 1.19–1.90], P < 0.001 compared to White race/ethnicity), and older age (peak adjusted IRR 4.95 [95% CI 3.99–6.14], P < 0.001 for patients ages 51–60 years versus those ages ≤10 years). Compared to controls, scleritis patients had a 2‐fold increased risk of a prior I‐IMID diagnosis (17 I‐IMIDs, P < 0.001) and significantly increased risk of subsequent diagnosis (13 I‐IMIDs). The I‐IMIDs most strongly associated with scleritis included granulomatosis with polyangiitis, Behçet’s disease, and Sjögren’s syndrome. Conclusion From 1997 through 2018, the UK incidence of scleritis declined from 4.23 to 2.79/100,000 person‐years. Incident scleritis was associated with 19 I‐IMIDs, providing data for rational investigation and cross‐specialty engagement.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Epidemiology of Scleritis in the United Kingdom From 1997 to 2018: Population‐Based Analysis of 11 Million Patients and Association Between Scleritis and Infectious and Immune‐Mediated Inflammatory Disease

Braithwaite

Adderley

Subramanian

et al. 2021

Arthritis & Rheumatology

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“…In a multicentric study by Lane et al ., presumed ocular tuberculosis accounted for 75% of infectious cases in India. [ 67 ] Tuberculous scleritis may be the result either of a direct MTB scleral invasion but more often is caused by an immune-mediated process[ 68 69 70 ] [Fig. 3a - c ].…”

Section: Types Of Infectious Scleritismentioning

confidence: 99%

Scleritis: Differentiating infectious from non-infectious entities

Murthy

Sabhapandit

Balamurugan

et al. 2020

Indian J Ophthalmol

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Scleritis is a rare painful ocular disorder, associated with severe ocular pain and tissue destruction. Although a majority of these cases are immune mediated and at least half of these are associated with systemic immune-mediated diseases, a smaller minority are due to infections of the sclera. The two conditions closely mimic each other, and a thorough knowledge of the subtle differences is necessary in order to reach a timely diagnosis. Diagnostic delay can lead to a poor outcome both due to the destruction caused by the uncontrolled infection and also due to propagation of the infection with the use of corticosteroids which may have been started for presumed immune mediated scleritis. In this review, we present the clinical features, etiological agents, and the differentiating features between immune and infectious scleritis. We also present diagnostic and management guidelines for managing scleral infection.

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“…[ 5 9 ] Also, our finding confirms scleritis in India affects relatively younger population than other parts of the world. [ 11 12 13 14 15 16 17 18 19 20 ] Relatively younger age at presentation (37 ± 21 years) was noted in patients with posterior scleritis. Most importantly, four out of five patients with scleritis were <50 years.…”

Section: Discussionmentioning

confidence: 99%

Clinical profile, treatment, and visual outcome of scleritis

Magesan

Patnaik

Majumder

et al. 2022

Oman Journal of Ophthalmology

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PURPOSE: The purpose of this study was to analyze the clinical profile of patients with scleritis managed by a single ophthalmologist in a tertiary eye care center. METHODS: This was a retrospective analysis of 107 eyes of 96 patients with scleritis from January 2007 to December 2018. RESULTS: Female predominance (68%) with a relatively young-onset (46 ± 14 years) of scleritis was observed. Diffuse anterior scleritis (41%) was the most common subtype of scleritis, and the most common systemic association was rheumatoid arthritis (18%). Three-fourth of patients received immunosuppressive treatment (74%) along with corticosteroids. The mean follow-up period was 3 ± 2.5 (range: 0.6–10) years. Necrotizing scleritis was at a 3.5 times higher risk of developing ocular complications. Eighty percent of patients maintained the same vision. Recurrence of scleritis was noted in 25 eyes (23%). CONCLUSION: Diffuse scleritis is the most common scleritis in our population. Tuberculosis was commonly seen with diffuse scleritis. The likelihood of developing ocular complications (cataract and glaucoma) was higher in necrotizing scleritis, thus requiring periodic monitorization.

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Clinical Features of Scleritis Across the Asia-Pacific Region

Abstract: Clinical presentations of scleritis vary across the Asia-Pacific, particularly in endemic regions for tuberculosis such as India, where it affects younger men with a predominance of nodular and infectious disease.

Cited by 28 publications

References 20 publications

Epidemiology of Scleritis in the United Kingdom From 1997 to 2018: Population‐Based Analysis of 11 Million Patients and Association Between Scleritis and Infectious and Immune‐Mediated Inflammatory Disease

Epidemiology of Scleritis in the United Kingdom From 1997 to 2018: Population‐Based Analysis of 11 Million Patients and Association Between Scleritis and Infectious and Immune‐Mediated Inflammatory Disease

Scleritis: Differentiating infectious from non-infectious entities

Clinical profile, treatment, and visual outcome of scleritis

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