Clinical features and presentation of posterior scleritis: a report of 31 cases

Ocul Immunol Inflamm. 2014 Jun;22(3):203-7. doi: 10.3109/09273948.2013.840385. Epub 2013 Oct 16.

Abstract

Purpose: To describe clinical features, ocular complications, and visual outcomes of patients with posterior scleritis.

Methods: Clinical characteristics of a subset of 31 patients with posterior scleritis were studied and compared with 469 patients with anterior scleritis.

Results: Of 500 patients, 31 (6.2%) had posterior scleritis. Most patients presented with subacute (80.6%), unilateral (61.3%) scleral inflammation. Pain was moderate to severe in 54.8% of patients. Concomitant anterior scleritis was observed during follow-up in 77.4% of patients and in all patients with moderate to severe pain. Patients with posterior scleritis were significantly younger (43.6 vs. 54.4 years, p < 0.001) and had significantly higher decrease of vision (29.0 vs. 14.9%, p = 0.027) than those with isolated anterior scleritis.

Conclusions: Posterior scleritis must be considered in patients with decrease of vision, mild to severe pain, optic disc edema, and/or posterior uveitis. Moderate to severe pain may be associated with poorer visual outcome.

Keywords: Inflammation; Ocular inflammatory disease; Sclera; Scleritis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Male
  • Middle Aged
  • Prevalence
  • Prognosis
  • Retrospective Studies
  • Sclera / pathology*
  • Scleritis / diagnosis*
  • Scleritis / drug therapy
  • Scleritis / epidemiology
  • Spain / epidemiology
  • Visual Acuity*
  • Young Adult

Substances

  • Immunosuppressive Agents