Epidemiology and visual outcomes in patients with infectious scleritis

Kelly L. Hodson, Anat Galor, Carol Karp, Janet L Davis, Thomas A Albini, Victor L Perez Quinones, Darlene Miller, Richard Forster

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

PURPOSE:: To describe the epidemiology of patients with infectious scleritis and identify factors associated with poor visual prognosis. METHODS:: Retrospective review of inciting factors, causative organisms, and visual outcomes of patients with infectious scleritis. RESULTS:: Fifty-five patients (56 eyes) with confirmed infectious scleritis were included. The median time from inciting event to scleritis symptoms was 1.9 months. Eyes with a history of pterygium surgery had a longer time from surgery to development of scleritis (median 49 months, range 0-183) compared to those with a history of glaucoma, cataract, and retina surgery (median 1.0-1.6 months; P = 0.001). Fungal, nocardial, and mycobacterial infections (median 17-45 days) had a longer interval between symptoms and diagnosis than eyes with non-acid-fast gram-positive and gram-negative bacteria (median 7 days; P = 0.04). Patients were followed for a median of 11.1 months (0.5-47 months). Approximately 50% of eyes lost functional vision (worse than 20/200). Presenting VA of worse than 20/200 and concomitant keratitis or endophthalmitis were associated with poorer VA outcomes. CONCLUSIONS:: Infectious scleritis can occur days to years after ocular surgery, with infection occurring after a longer interval in eyes with a history of pterygium surgery. Approximately 50% of eyes lost functional VA after infection with poor presenting VA being the strongest predictor for subsequent severe vision loss.

Original languageEnglish
Pages (from-to)466-472
Number of pages7
JournalCornea
Volume32
Issue number4
DOIs
StatePublished - Apr 1 2013

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Scleritis
Epidemiology
Pterygium
Infection
Endophthalmitis
Keratitis
Gram-Negative Bacteria
Glaucoma
Cataract
Retina

Keywords

  • epidemiology
  • infectious scleritis

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Epidemiology and visual outcomes in patients with infectious scleritis. / Hodson, Kelly L.; Galor, Anat; Karp, Carol; Davis, Janet L; Albini, Thomas A; Perez Quinones, Victor L; Miller, Darlene; Forster, Richard.

In: Cornea, Vol. 32, No. 4, 01.04.2013, p. 466-472.

Research output: Contribution to journalArticle

Hodson, Kelly L. ; Galor, Anat ; Karp, Carol ; Davis, Janet L ; Albini, Thomas A ; Perez Quinones, Victor L ; Miller, Darlene ; Forster, Richard. / Epidemiology and visual outcomes in patients with infectious scleritis. In: Cornea. 2013 ; Vol. 32, No. 4. pp. 466-472.
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AB - PURPOSE:: To describe the epidemiology of patients with infectious scleritis and identify factors associated with poor visual prognosis. METHODS:: Retrospective review of inciting factors, causative organisms, and visual outcomes of patients with infectious scleritis. RESULTS:: Fifty-five patients (56 eyes) with confirmed infectious scleritis were included. The median time from inciting event to scleritis symptoms was 1.9 months. Eyes with a history of pterygium surgery had a longer time from surgery to development of scleritis (median 49 months, range 0-183) compared to those with a history of glaucoma, cataract, and retina surgery (median 1.0-1.6 months; P = 0.001). Fungal, nocardial, and mycobacterial infections (median 17-45 days) had a longer interval between symptoms and diagnosis than eyes with non-acid-fast gram-positive and gram-negative bacteria (median 7 days; P = 0.04). Patients were followed for a median of 11.1 months (0.5-47 months). Approximately 50% of eyes lost functional vision (worse than 20/200). Presenting VA of worse than 20/200 and concomitant keratitis or endophthalmitis were associated with poorer VA outcomes. CONCLUSIONS:: Infectious scleritis can occur days to years after ocular surgery, with infection occurring after a longer interval in eyes with a history of pterygium surgery. Approximately 50% of eyes lost functional VA after infection with poor presenting VA being the strongest predictor for subsequent severe vision loss.

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