Scleritis: challenges in immunopathogenesis and treatment.

Area of Science:

• Ophthalmology
• Immunology

Background:

• Scleritis is an uncommon inflammatory disease affecting the sclera and surrounding eye structures.
• It is a potentially sight-threatening condition requiring effective management strategies.

Purpose of the Study:

• To review recent advances in understanding scleritis epidemiology, immunopathogenesis, and treatment.
• To identify remaining challenges in managing scleral inflammation and destruction.

Main Methods:

• Review of recent studies on scleritis, including those related to systemic diseases and vasculitis.
• Analysis of research on ocular tissue to understand inflammatory mechanisms.
• Evaluation of clinical trials for various therapeutic interventions.

Main Results:

• Significant progress has been made in understanding scleritis's epidemiology and immunopathogenesis.
• T and B cells, autoantibodies, immune complexes, and cytokines like TNF-alpha play a key role.
• Clinical trials show effectiveness of anti-TNF, anti-B cell therapy, immunosuppression, and local steroid treatment.

Conclusions:

• Despite advances, challenges remain in understanding scleral destruction mechanisms.
• Current research supports a multi-faceted approach to scleritis treatment, including targeted immunotherapies and localized treatments.