[Scleritis, clinical features, etiologies and treatment: a case series of 32 patients].

Abstract

PURPOSE:

To report on the various clinical presentations, etiological diagnosis, prognosis and treatment of patients with scleritis evaluated at a tertiary care eye center.

METHODS:

Retrospective, monocentric study on a series of 32 patients in a tertiary center.

RESULTS:

The mean age of included patients with scleritis was 46.8 years (range, 22 to 77 years). Nineteen patients were women and 13 were men. Twenty-six patients (81%) had anterior scleritis (15 nodular, 8 diffuse and 3 necrotizing), six (19%) had posterior scleritis. Unilateral inflammation was present in 24 patients (75%). Twelve out of the 32 patients (37.5%) had an underlying systemic disease: granulomatosis with polyangiitis (n=3), Behçet's disease (n=2), unspecified inflammatory arthritis (n=2), psoriatic arthritis (n=1), ankylosing spondylitis (n=1), sarcoidosis (n=1), Cogan's syndrome (n=1) and ulcerative colitis (n=1). Six patients (18.8%) were suspected of having infectious disease with herpes virus: clinical context and positive treatment response with oral valacyclovir. Systemic agents and topical agents were required in 28 patients (87.5%). The first line therapy was mainly oral non-steroidal anti-inflammatory drugs in 15 patients (47%) and oral corticosteroids in 8 (25%). Immunosuppressive drugs were required in 6 patients. The mean follow-up was 16.3 months. Six patients (19%) had a decrease in visual acuity.

CONCLUSION:

The number of systemic disease in our series is similar to the main series in the literature. Treatment with valaciclovir might be effective in patients with suspected herpes simplex scleritis.

• Authors: C Leal, K Le Roux, A Rahmi, L Varron, C Broussolle, P Denis, L Kodjikian, P Sève
• Journal: La Revue de medecine interne (Rev Med Interne) Vol. 35 Issue 8 Pg. 491-7 (Aug 2014) ISSN: 1768-3122 [Electronic] France
• Vernacular Title: Sclérites, aspects cliniques, étiologiques et thérapeutiques : à propos d'une série de 32 observations.
• PMID: 24210266 (Publication Type: Journal Article)
• Copyright: Copyright © 2013. Published by Elsevier SAS.

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• Antiviral Agents
• Glucocorticoids
• Immunosuppressive Agents
• Valine
• Valacyclovir
• Acyclovir

Topics

• Academic Medical Centers
• Acyclovir (analogs & derivatives, therapeutic use)
• Adult
• Aged
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Antiviral Agents (therapeutic use)
• Drug Therapy, Combination
• Female
• Follow-Up Studies
• Glucocorticoids (therapeutic use)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Male
• Middle Aged
• Prognosis
• Retrospective Studies
• Risk Factors
• Scleritis (diagnosis, drug therapy, etiology, virology)
• Treatment Outcome
• Valacyclovir
• Valine (analogs & derivatives, therapeutic use)