Clinical Features, Treatment, and Visual Outcomes of Japanese Patients with Posterior Scleritis

Ando, Yoshimasa; Keino, Hiroshi; Nakayama, Makiko; Watanabe, Takayo; Okada, Annabelle A.

doi:10.1080/09273948.2019.1574838

Cited by 13 publications

(15 citation statements)

References 19 publications

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“…1). In a retrospective review published by Ando et al subfoveal choroidal thickness, measured with EDI-OCT, was increased at presentation; and decreased with successful treatment during the follow-up period (mean choroidal thickness at presentation was 611 ± 148 μm, decreasing to 298 ± 75 μm (p < 0.01) at 1 month, and further decreasing afterwards) [14]. Dong and colleagues reported similar findings in a retrospective study of 23 patients with posterior scleritis and concurrent serous retinal detachment [20].…”

Section: Choroidal Thicknessmentioning

confidence: 93%

“…It is an uncommon condition, affecting between 2.0 and 17.7% of all scleritis patients in retrospective epidemiological studies [2][3][4][5][6][7][8][9][10][11][12]. Posterior scleritis is reported to have a female preponderance in the majority of case series and can occur in all decades of life (Table 1) [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28].…”

Section: Introductionmentioning

confidence: 99%

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Choroidal involvement in non-infectious posterior scleritis

Vermeirsch

Testi

Pavésio

2021

J Ophthal Inflamm Infect

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Purpose To provide a comprehensive overview of choroidal involvement in non-infectious posterior scleritis; including different imaging modalities and their clinical usefulness. Methods Narrative review. Results Posterior scleritis is an uncommon yet potentially sight-threatening inflammation of the sclera. During the disease process, inflammation can spread to the adjacent choroid, causing different manifestations of choroidal involvement: (1) increased choroidal thickness, (2) choroidal vasculitis, (3) presentation as a choroidal or subretinal mass in nodular posterior scleritis, and (4) choroidal folds, choroidal effusion and exudative retinal detachment. Conclusions Clinical characteristics and multimodal imaging can aid in diagnosing and monitoring disease progression and response to treatment in non-infectious posterior scleritis with choroidal involvement.

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Section: Choroidal Thicknessmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Choroidal involvement in non-infectious posterior scleritis

Vermeirsch

Testi

Pavésio

2021

J Ophthal Inflamm Infect

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“…B-mode ultrasonography shows scleral thickening, scleral nodules, dissection of the Tenon capsule from the sclera, and exophthalmos [ 9 ]. Optical coherence tomography (OCT) shows optic papillary oedema, choroidal folds at the posterior pole, and exudative retinal detachment, and imaging is useful for diagnosis and the evaluation of disease activity [ 10 , 11 , 12 ]. Anterior scleritis and uveitis may also be present [ 13 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…In Japan, the frequency of scleritis associated with systemic autoimmune diseases is about 30% [ 10 , 16 ], and in Europe and the United States, it is reported to be 30–50% [ 17 , 18 ]. Wirnringa et al reported that 32.7% of scleritis patients had a background disease, of which 29.8% were autoimmune diseases, most commonly rheumatoid arthritis, and 2.9% were infections due to herpes or syphilis.…”

Section: Introductionmentioning

confidence: 99%

Immunopathological Analysis of a Mouse Model of Arthritis-Associated Scleritis and Implications for Molecular Targeted Therapy for Severe Scleritis

Nishio

Taniguchi

Takeda

et al. 2021

IJMS

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Scleritis involves inflammation of the sclera, which constitutes 75% of the wall of the eye. This pathology is often seen as an ocular lesion associated with systemic inflammatory diseases. Severe types of scleritis such as posterior scleritis require urgent immunosuppressive treatments, including molecularly targeted therapies to avoid permanent visual impairment. Which molecules should be selected as targets has remained unclear. To clarify the pathogenesis of scleritis and propose appropriate target molecules for therapy, we have established novel animal model of scleritis by modifying the Collagen-II Induced Arthritis (CIA) model. Immunization twice with collagen II emulsified with complete Freund’s adjuvant (CFA) caused arthritis and scleritis. The clinical appearance resembled human diffuse scleritis. Histopathological analysis suggested that macrophages, plasma cells, deposition of immune complexes, and growth of blood and lymphatic vessels are involved in the pathogenesis of CIA-associated scleritis. In addition, we analysed the background diseases of posterior scleritis and responses to molecularly targeted therapies as a case series study. We inferred from both the animal model and case series study that targets should not be T cells, but factors inhibiting macrophage activity such as tumor necrosis factor (TNF) and interleukin (IL)-6, and molecules suppressing antibody-producing cells such as CD20 on B cells should be targeted by molecularly targeted therapies.

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“…The clinical presentation of bilateral posterior scleritis is very diverse, further complicating diagnosis[ 2 ]. The versatile clinical signs of posterior scleritis include retinal striae, fluid accumulation under the retina (which leads to retinal detachment), retinal pigment epithelial (RPE) folds, optic disk edema, and choroidal thickening[ 3 ]. Among all cases of scleritis, the overall frequency of intraocular hypertension is low (12.6%[ 1 ]).…”

Section: Introductionmentioning

confidence: 99%

Bilateral posterior scleritis presenting as acute primary angle closure: A case report

Chen

Duan

2021

WJCC

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BACKGROUND Scleritis is a rare disease and the incidence of bilateral posterior scleritis is even rarer. Unfortunately, misdiagnosis of the latter is common due to its insidious onset, atypical symptoms, and varied manifestations. We report here a case of bilateral posterior scleritis that presented with acute eye pain and intraocular hypertension, and was initially misdiagnosed as acute primary angle closure. Expanding the literature on such cases will not only increase physicians’ awareness but also help to improve accurate diagnosis. CASE SUMMARY A 53-year-old man was referred to our hospital to address a 4-d history of bilateral acute eye pain, headache, and loss of vision, after initial presentation to a local hospital 3 d prior. Our initial examination revealed bilateral cornea edema accompanied by a shallow anterior chamber and visual acuity reduction, with left-eye amblyopia (> 30 years). There was bilateral hypertension (by intraocular pressure: 28 mmHg in right, 34 mmHg in left) and normal fundi. Accordingly, acute primary angle closure was diagnosed. Miotics and ocular hypotensive drugs were prescribed, but the symptoms continued to worsen over the 3-d treatment course. Further imaging examinations ( i.e. , anterior segment photography and ultrasonography) indicated a diagnosis of bilateral posterior scleritis. Methylprednisolone, topical atropine, and steroid eye drops were prescribed along with intraocular pressure-lowering agents. Subsequent optical coherence tomography (OCT) showed gradual improvements in subretinal fluid under the sensory retina, thickened sclera, and ciliary body detachment. CONCLUSION Bilateral posterior scleritis can lead to secondary acute angle closure. Diagnosis requires ophthalmic accessory examinations ( i.e ., ultrasound biomicroscopy, B-scan, and OCT).

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Clinical Features, Treatment, and Visual Outcomes of Japanese Patients with Posterior Scleritis

Cited by 13 publications

References 19 publications

Choroidal involvement in non-infectious posterior scleritis

Choroidal involvement in non-infectious posterior scleritis

Immunopathological Analysis of a Mouse Model of Arthritis-Associated Scleritis and Implications for Molecular Targeted Therapy for Severe Scleritis

Bilateral posterior scleritis presenting as acute primary angle closure: A case report

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