Non-infectious scleritis and systemic collagen vascular disease association

Abstract

© 2020 Faculty of Medicine Siriraj Hospital, Mahidol University. Objective: To evaluate the differences between scleritis in association with a systemic collagen vascular disease and idiopathic scleritis and to describe the clinical characteristics of patients presenting with non-infectious scleritis. Methods: A retrospective cohort study of 95 patients who presented with non-infectious scleritis was conducted. A comparison of the clinical differences between patients who had an associated systemic collagen vascular disease and idiopathic scleritis was performed. Results: Of the 95 patients (123 eyes), 72.6% was female with mean age of 47 years. Diffuse anterior scleritis was the most predominant type (57.9%). The first and the second most frequent complications were anterior uveitis and scleral thinning. Almost twenty percent of the patients had a systemic collagen vascular disease involvement; rheumatoid arthritis and non-specific anti-neutrophil cytoplasmic antibodies-related scleritis were the two most common (4.2% each). Most of the patients who had a concurrent systemic collagen vascular disease presented with diffuse anterior scleritis, but it was not statistically significant compared with the idiopathic group. The presence of scleral thinning during follow-up periods showed a statistically significant difference between the groups with and without systemic collagen vascular disease at p value 0.038. Conclusion: Diffuse anterior scleritis was the most common type of scleritis found. Patients who had collagen vascular disease and scleritis commonly developed scleral thinning during follow up visits. Aggressive treatment for scleritis in immune-mediated systemic collagen vascular disease may be considered to prevent progressive scleral thinning.