Clinical Profile of Patients with Necrotizing Scleritis in a Tertiary Eye Care Center in Southern India

Ocul Immunol Inflamm. 2018;26(3):412-416. doi: 10.1080/09273948.2016.1223857. Epub 2016 Oct 20.

Abstract

Purpose: To report the clinical profile of a series of necrotizing scleritis in an Indian population.

Methods: A retrospective medical record review of 27 consecutive patients with necrotizing scleritis. Patient demographics, ocular and systemic findings, treatment modalities, and visual outcome were recorded.

Results: There were 19 males and 8 females (31 eyes) with mean age at presentation of 49.5 years (range: 30-84 years). Underlying immunologically induced disorders was present in 37%. In 70% of the cases with immunologically induced disorders, necrotizing scleritis was the initial presentation. Complicated cataract (25.8%) and exudative retinal detachment (9.6%) were the most common anterior and posterior segment complications, respectively. Cyclophosphamide was the most commonly used immunosuppressive (55.56%) and proved to be the most effective. But even with the best available treatment, globe perforation was encountered in two eyes.

Conclusions: Necrotizing scleritis can be the initial presentation of immunologically induced disorders. This disease entity is plagued with a high rate of ocular complications, especially those which can be devastating, such as globe perforation. Early and intensive therapy can be helpful in salvaging the eye.

Keywords: Clinical profile; immunologically induced disorders; inflammatory; necrotizing scleritis; schleral necrosis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cyclophosphamide / therapeutic use
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • India / epidemiology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Scleritis / diagnosis*
  • Scleritis / drug therapy
  • Scleritis / epidemiology*
  • Tertiary Care Centers / statistics & numerical data
  • Visual Acuity / physiology
  • Young Adult

Substances

  • Glucocorticoids
  • Immunosuppressive Agents
  • Cyclophosphamide