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Rheumatoid Arthritis Associated Episcleritis and Scleritis: An Update on Treatment Perspectives.
Veronique Promelle1,2, Vincent Goeb2,3, Julie Gueudry4,5
1Department of Ophthalmology and Visual Sciences, The Hospital for Sick Children, University of Toronto, Toronto, ON M5G 1X8, Canada.
Journal of Clinical Medicine
|June 2, 2021
Summary
Rheumatoid arthritis (RA) commonly causes eye inflammation like episcleritis and scleritis. Newer biologic agents offer effective treatment for severe cases, improving patient outcomes.
Area of Science:
- Ophthalmology
- Rheumatology
- Immunology
Background:
- Episcleritis and scleritis are common ocular manifestations of rheumatoid arthritis (RA).
- RA-associated scleritis presents with higher risks of ocular complications and refractory inflammation.
- Scleritis can be an early sign of rheumatoid vasculitis, necessitating prompt diagnosis and management.
Purpose of the Study:
- To review the diagnosis and management of RA-associated episcleritis and scleritis.
- To highlight recent advancements in treatment strategies for these conditions.
- To emphasize the importance of interdisciplinary collaboration between rheumatologists and ophthalmologists.
Main Methods:
- Literature review of diagnosis and management of RA-associated ocular inflammation.
- Analysis of current and emerging treatment options, including conventional therapies and biologics.
- Discussion of clinical presentation and risk factors in RA patients.
Main Results:
- Episcleritis typically responds to NSAIDs and topical steroids.
- Scleritis management involves NSAIDs, steroids, and potentially DMARDs.
- Refractory cases benefit from anti-TNF biologics (infliximab, adalimumab), with other agents like rituximab showing promise.
Conclusions:
- RA-associated episcleritis and scleritis require tailored management strategies.
- Biologic agents are crucial for refractory scleritis, with ongoing research into novel therapies.
- Close collaboration between rheumatology and ophthalmology is essential for optimal patient care and early detection of systemic disease.
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