Scleritis and Systemic Disease Association in a Community-Based Referral Practice

Raiji, Veena; Palestine, Alan G.; Parver, David L.

doi:10.1016/j.ajo.2009.07.021

Cited by 68 publications

(25 citation statements)

References 24 publications

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“…Regarding the behavior of scleritis and therapeutic response, both groups showed similar results, independently of the systemic disease. Patients with and without associated systemic disease were likely to require systemic therapy (94.4% and 100%, respectively), as related in recent literature (30) . During the therapeutic follow-up of IS patients, the medications used during a crisis were maintained, trying to reduce or even suspend at first the use of systemic corticoids, followed by the immunosuppressors (8,(31)(32)(33)(34) .…”

Section: Discussionsupporting

confidence: 52%

Comparative study of ophthalmological and serological manifestations and the therapeutic response of patients with isolated scleritis and scleritis associated with systemic diseases

Sousa

Trevisani

Modolo

et al. 2011

Arq. Bras. Oftalmol.

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Introduction: Scleritis is a rare, progressive and serious disease, the signs of which are inflammation and edema of episcleral and scleral tissues and is greatly associated with systemic rheumatoid diseases. Purpose: To perform a prospective and comparative study between ophthalmologic manifestations, serologic findings and therapeutic response of patients with isolated scleritis and scleritis associated with systemic rheumatoid disease. Methods: Thirty-two outpatients with non-infectious scleritis were studied, from March 2006 to March 2008. The treatment was corticoid eye drops associated with antiinflammatory agents, followed by systemic corticoids and immunosuppressive drugs if necessary, was considered successful after six months without scleritis recurrence. Results: Fourteen of 32 patients had scleritis associated with systemic rheumatoid disease, of which nine had rheumatoid arthritis, two systemic lupus erythematosus, one Crohn's disease, one Behçet's disease and one gout. There were no difference in relation to involvement and ocular complications, there was predominance of nodular anterior scleritis and scleral thinning was the most frequent complication. The scleritis associated with systemic rheumatoid disease group had 64.3% of autoantibodies, versus 27.8% among those with isolated scleritis and this difference was statistically significant. In the isolated scleritis group 16.7% used anti-inflammatory, 33.3% corticosteroids, 27.8% corticosteroids with one immunosuppressive drug, 5.5% two immunosuppressive drugs, 16.7% corticosteroids with two immunosuppressive drugs and 33.3% pulse of immunosuppressive drugs, there was remission in 88.9%. In the scleritis associated with systemic rheumatoid disease group 7.1% used anti-inflammatory, 7.1% corticosteroids, 50% corticosteroids with one immunosuppressive drug, 7.1% two immunosuppressive drugs and 22.2% pulse of immunosuppressive drugs, 100% had treatment success. Conclusion: Prevalence of unilateral nodular scleritis was noted in both groups and higher rates of all the parameters tested were noted in the scleritis associated with systemic rheumatoid disease group. There were no differences between the groups with respect to the use of immunosuppressive drugs and therapeutic response, which was fully satisfactory in the scleritis associated with systemic rheumatoid disease group and satisfactory in the isolated scleritis group.

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Section: Discussionsupporting

confidence: 52%

Comparative study of ophthalmological and serological manifestations and the therapeutic response of patients with isolated scleritis and scleritis associated with systemic diseases

Sousa

Trevisani

Modolo

et al. 2011

Arq. Bras. Oftalmol.

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“…It has been reported that 40–50% of patients with scleritis may have an underlying systemic disease, with the most common being rheumatoid arthritis and GPA [5, 6]. Scleritis in GPA can be diffuse, nodular, or necrotizing.…”

Section: Introductionmentioning

confidence: 99%

Cyclophosphamide or Rituximab Treatment of Scleritis and Uveitis for Patients with Granulomatosis with Polyangiitis

Ahmed

Foster

2018

Ophthalmic Res

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Purpose: Vision-threatening ocular inflammation can be a devastating complication of granulomatosis with polyangiitis (GPA). Here we performed a retrospective observational study to describe the safety and efficacy of treating scleritis and uveitis with either cyclophosphamide or rituximab in GPA. Methods: A chart review of patients diagnosed with GPA-associated scleritis or uveitis, treated with either cyclophosphamide or rituximab as the final therapy at our clinic, was conducted. A total of 1 year of follow-up visits was required for inclusion in the study. Results: Thirteen patients (19 eyes) suffering from GPA-associated scleritis and/or uveitis were identified. As the final therapy, rituximab was administered to 9 patients and cyclophosphamide to 4. Mean duration of follow-up was 55 months (range 16–23 months). Remission was observed in all patients. Three patients had a flare of scleritis after the completion of therapy, and they were restarted on their respective agents. One patient had a flare of retinal vasculitis during rituximab therapy. One patient on cyclophosphamide experienced transient leukopenia. No adverse side effects of rituximab were noted throughout the course of treatment. Conclusions: Cyclophosphamide and rituximab are safe and effective agents for controlling scleritis and uveitis associated with GPA, with eventual progression towards steroid-sparing remission.

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“…119 Although cases are usually treated empirically with antiinflammatory therapy and often resolve uneventfully, physicians must be wary of potentially sight-threatening persistent cases with etiologies requiring a more extensive work-up.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Treatment and management of scleral disorders

Diaz

Sobol

Gritz

2016

Survey of Ophthalmology

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Scleritis and Systemic Disease Association in a Community-Based Referral Practice

Cited by 68 publications

References 24 publications

Comparative study of ophthalmological and serological manifestations and the therapeutic response of patients with isolated scleritis and scleritis associated with systemic diseases

Comparative study of ophthalmological and serological manifestations and the therapeutic response of patients with isolated scleritis and scleritis associated with systemic diseases

Cyclophosphamide or Rituximab Treatment of Scleritis and Uveitis for Patients with Granulomatosis with Polyangiitis

Treatment and management of scleral disorders

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