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Published on: May 5, 2022
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Five-year outcome in immune-mediated scleritis.
Wolfgang Bernauer1, Beat Pleisch, Matthias Brunner
1OMMA Eye Center, Theaterstrasse 2, 8001, Zürich, Switzerland, wolfgang.bernauer@hin.ch.
Summary
Systemic diseases and positive auto-antibodies are linked to persistent immune-mediated scleritis. Immunosuppressive therapy effectively controls ocular inflammation but may lead to severe systemic complications.
Area of Science:
- Ophthalmology
- Rheumatology
- Immunology
Background:
- Immune-mediated scleritis is a rare condition with limited data on its clinical course and complications.
- Understanding prognostic factors and therapeutic outcomes is crucial for managing this condition.
Purpose of the Study:
- To identify prognostic factors associated with persistent immune-mediated scleritis.
- To document the complications and therapeutic effects in patients with immune-mediated scleritis over a 5-year period.
Main Methods:
- A retrospective, non-comparative, interventional case series design was employed.
- Data collected included systemic disease, laboratory findings, scleritis type, disease activity, therapy, and complications for patients with a 5-year follow-up.
Main Results:
- Systemic diseases were present in 37% at baseline and 45% at 5 years, with rheumatoid arthritis being most common.
- Persistent scleritis (>5 years) correlated with systemic disease (66% vs. 6%) and positive auto-antibodies (48% vs. 23%).
- Ocular inflammation control was achieved in 95% of patients using prednisone and/or methotrexate; complications included keratitis, corneal melt, and macular edema.
Conclusions:
- Systemic disease and positive auto-antibodies are significant predictors of persistent immune-mediated scleritis.
- Immunosuppressive agents are effective for scleritis control but carry a risk of severe systemic complications.
