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: 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.