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Scleritis associated with systemic vasculitic diseases

M Sainz de la Maza1, C S Foster, N S Jabbur

  • 1Ocular Immunology Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston 02114, USA.

Ophthalmology
|April 1, 1995
PubMed
Summary

Scleritis associated with systemic vasculitic diseases has variable ocular prognoses. Scleritis in Wegener granulomatosis is severe, while spondyloarthropathies and lupus erythematosus cases are generally benign.

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Area of Science:

  • Ophthalmology
  • Rheumatology
  • Immunology

Background:

  • Scleritis can be a manifestation of systemic vasculitic diseases.
  • Systemic vasculitis in scleritis patients indicates a poor prognosis due to potential systemic complications.
  • Understanding the ocular prognosis based on the specific vasculitic disease is crucial.

Purpose of the Study:

  • To analyze the ocular prognosis of patients diagnosed with scleritis.
  • To compare the outcomes of scleritis across different types of systemic vasculitic diseases.

Main Methods:

  • Evaluation of patient characteristics, scleritis type, and ocular complications in 82 patients.
  • Comparative analysis between scleritis patients with specific systemic vasculitic diseases and others.

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Main Results:

  • Wegener granulomatosis associated scleritis showed higher rates of necrotizing scleritis (79%), vision decrease (79%), and peripheral ulcerative keratitis (50%).
  • Spondyloarthropathies associated scleritis presented with less vision decrease (8%) and peripheral ulcerative keratitis (0%).
  • Systemic lupus erythematosus associated scleritis had a lower incidence of necrotizing scleritis (0%).

Conclusions:

  • Ocular prognosis for scleritis varies significantly with the underlying systemic vasculitic disease.
  • Scleritis in spondyloarthropathies and systemic lupus erythematosus is typically benign and self-limiting.
  • Scleritis in Wegener granulomatosis poses a severe risk of permanent blindness; rheumatoid arthritis and relapsing polychondritis require close monitoring for ocular complications.