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Necrotizing Scleritis: A Review
Parthopratim Dutta Majumder1, Shweta Agarwal2, Mauli Shah1
1Department of Uvea Services, Medical Research Foundation, Sankara Nethralaya, Chennai, India.
Ocular Immunology and Inflammation
|June 6, 2023
Summary
Necrotizing scleritis, a severe eye condition, often links to autoimmune diseases or infections. Differentiating between infectious and non-infectious causes is crucial for effective treatment and preventing vision loss.
Area of Science:
- Ophthalmology
- Rheumatology
- Infectious Diseases
Background:
- Necrotizing scleritis is the most destructive and vision-threatening form of scleritis.
- It can be associated with systemic autoimmune disorders, systemic vasculitis, or microbial infections.
- Rheumatoid arthritis and granulomatosis with polyangiitis are common systemic diseases linked to necrotizing scleritis.
Purpose of the Study:
- To highlight the critical importance of differentiating between infectious and non-infectious necrotizing scleritis.
- To discuss the management strategies for both forms of necrotizing scleritis.
- To emphasize the complications associated with necrotizing scleritis.
Main Methods:
- Review of literature on necrotizing scleritis.
- Analysis of common causes, risk factors, and associated systemic diseases.
- Comparison of treatment modalities for infectious and non-infectious necrotizing scleritis.
Main Results:
- Pseudomonas species is the most common cause of infectious necrotizing scleritis, with surgery being a common risk factor.
- Necrotizing scleritis has high complication rates, including secondary glaucoma and cataract.
- Distinguishing between infectious and non-infectious forms is challenging but essential for management.
Conclusions:
- Non-infectious necrotizing scleritis requires aggressive immunosuppressive therapy.
- Infectious necrotizing scleritis necessitates long-term antimicrobial treatment and surgical intervention due to deep infection and scleral avascularity.
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