No abstract available.
Hyperplasia* ; Scleritis*

Posterior scleritis must be one of the most underdiagnosed treatable conditions in ophthalmology, partly because its manifestations are so protean and partly because the diagnosis is rarely considered. Although ultrasonography and computer tomogram are ancilliary tests, a careful examination of the posterior segment of the eye including the area of the ora serrata, macula and disc is essential to discover the presence of a posterior scleritis. We experienced prolonged retinal pigment epithelial detachments which had appered at early phase of posterior scleritis.
Bruch Membrane ; Diagnosis ; Ophthalmology ; Retinal Detachment* ; Retinaldehyde* ; Scleritis* ; Ultrasonography

PURPOSE: To evaluate the clinical features of the patients with episcleritis and scleritis. METHODS: Retrospective chart review was performed for above patients that had been followed from 1986. 8. 8 to 2001. 6. 4. RESULTS: The number of patients with episcleritis was 17 (49%) and that of scleritis was 18 (51%). Ocular complication occurred in 59% of patients with episcleritis and 72% of patients with scleritis. Keratitis was the most common ocular complication. No patient with episcleritis had a decrease in visual acuity, whereas 33% of patients with scleritis did. Systemic diseases were found in 69% of episcleritis whereas 77% of patients with scleritis associated with systemic diseases. Rheumatoid arthritis was the most common one in both groups of patients. CONCLUSIONS: Ocular complications, systemic diseases, and decrease in visual acuity are associated more of commonly with scleritis than episcleritis. When scleritis is suspected, careful examinations for associated ocular complications should be performed and be followed with history taking and evaluation for associated systemic disease.
Arthritis, Rheumatoid ; Humans ; Keratitis ; Retrospective Studies ; Scleritis* ; Visual Acuity

PURPOSE: To evaluate serologic tests and therapeutic drugs of the patients with episcleritis and scleritis. METHODS: Retrospective chart review was performed for above patients that had been followed from 1986. 8. 8 to 2001. 6. 4. RESULTS: Of a total of 26 patients, 5 patients (38.5%) with episcleritis and 7 patients (53.8%) with scleritis showed seropositivity. Rheumatoid factor (RF) (26.1%) and antinuclear antibody (ANA) (26.1%) were most commonly positive. Eleven patients (84.6%) with episcleritis group were given topical steroid, 3 patients (23.1%) were treated with systemic drugs due to ocular lesions, and 6 patients (46.2%) with systemic drug for underlying systemic diseases. In scleritis group, 11 patients (84.6%) were treated with topical steroid, 2 patients (15.4%) with systemic drugs for ocular lesions, and 7 patients (53.8%) with systemic drug for underlying systemic diseases. An average period of treatment time was 6.4 weeks in episcleritis and 11.1 weeks in scleritis. CONCLUSIONS: Serologic tests help document the underlying disorders in patients with scleritis and in those with persistent or often recurred episcleritis. Also treatment of episcleritis and scleritis requires understanding possible effects of systemic drugs adminstered for underlying disorder on ocular lesion, and requires cooperation with internists and rheumatolgists.
Antibodies, Antinuclear ; Humans ; Retrospective Studies ; Rheumatoid Factor ; Scleritis* ; Serologic Tests*

PURPOSE: To assess the proper differential diagnosis and treatment of scleritis with scleral melt following pterygium excision. METHODS: A retrospective study through a review of medical records of 5 patients diagnosed with surgically induced necrotizing scleritis (SINS) after pterygium excision and treated with systemic immunosuppressant and steroid. RESULTS: All the patients responded to the treatment and showed significant improvement. CONCLUSIONS: Immunosuppressive treatment without surgical intervention is effective in resolution of SINS after pterygium excision.
Diagnosis, Differential ; Humans ; Medical Records ; Pterygium* ; Retrospective Studies ; Scleritis*

No abstract available.
Adult ; Female ; Humans ; Recurrence ; Retina/*pathology ; Scleritis/*complications/diagnosis ; Tomography, Optical Coherence ; Uveomeningoencephalitic Syndrome/complications/*diagnosis

PURPOSE: To report a case of a patient with intractable scleritis with conventional immunosuppressive therapy who showed effective treatment with infliximab. CASE SUMMARY: A 71-year-old man presented with orbital cellulitis and diffuse anterior scleritis of his left eye. Although orbital cellulites showed remission with topical and systemic antibiotics, scleritis persisted despite a combination therapy of immunosuppressive agents (cyclosporin, mycophenolate, prednisolone) for 1 month. Finally, he was given infliximab (5 mg/kg) intravenously three times at 2-week intervals, after which ocular pain, chemosis, conjunctival injection, and sclera thickening considerably reduced, and scleritis completely remitted. CONCLUSIONS: The administration of Infliximab seems to be an effective therapy in patients with intractable scleritis undergoing conventional therapy.
Aged ; Anti-Bacterial Agents ; Antibodies, Monoclonal ; Eye ; Humans ; Immunosuppressive Agents ; Orbit ; Orbital Cellulitis ; Sclera ; Scleritis ; Infliximab

PURPOSE: To investigate the efficacy of amniotic membrane transplantation (AMT) in patients who were diagnosed with necrotizing scleritis after pterygium excision and who were refractory to systemic corticosteroid and immunosuppressive therapy. METHODS: Six patients who had persistent scleral melting with systemic corticosteroid or immunosuppressive agents underwent double AMT as a permanent patch graft and temporary overlying barrier. Postoperatively, the symptom improvements, reepithelization times and visual acuity changes were evaluated. RESULTS: Choroidal detachment was detected in two patients preoperatively. In all patients, ocular pain improved at 4.7 +/- 3.1 days, and reepithelization of the scleral lesions was completed at 13.2 +/- 8.1 days postoperatively. Choroidal detachment in two patients disappeared at postoperative 2 and 8 days. Complete remission was found in 5 of the 6 eyes (83.3%). One eye which achieved full epithelization in the necrotic area experienced recurrent nodular scleritis in another quadrant, resulting in remission after changing the regimen of immunosuppressive agents. Mean values of initial and final visual acuities were 0.898 logMAR and 0.428 logMAR, respectively, and the visual acuities improved in all patients. CONCLUSIONS: AMT is effective in promoting reepithelization of the necrotic area, resulting in complete remission of necrotizing scleritis in patients who were refractory to systemic corticosteroid or immunosuppressive therapy.
Amnion* ; Choroid ; Freezing ; Humans ; Immunosuppressive Agents ; Pterygium* ; Scleritis* ; Transplants ; Visual Acuity

The scleritis is developed after taruma, infection or associated with systemic disease in 505 such as connective tissue disease, granulomatous disease & metabolic disease, in which the most common disease is rheumatoid arthritis[RA]. Scleromalacia perforans characterized by progressive thinning of the sclera in the absence of symtoms and with minimal inflammatory signs is a typical type of scleritis in rhematoid arthritis patient. And necrotizing scleritis is associated with long-standing and severe RA in 4-10%. However, there has been no effective method for preventing those diseases. In order to prevent recurrence of pterygium, anti-metabolic agent or radioactive material has been applied to excision site. However, in case of RA, excessive application of above method or aggressive excision of pterygeal mass is rather avoided to prevent postoperative necrotizing scleritis. In this study, we reported a case of enucleation with histology due to severe necrotizing scleritis with extensive exposure of choroid in a 67-year-old man having a past history of RA for 20 years and pterygium excision[OS] 15 years ago.
Aged ; Arthritis ; Arthritis, Rheumatoid* ; Choroid ; Connective Tissue Diseases ; Humans ; Metabolic Diseases ; Pterygium* ; Recurrence ; Sclera ; Scleritis*

Rheumatic diseases are associated various extra-articular manifestations, such as eye, nerve, pericardium, and pleura. The anterior part of the eye has distinguished anatomic structure resembling synovial joints, thus it is a common site of ocular manifestation in rheumatic disease. These changes include sicca syndrome, peripheral ulcerative keratitis, episcleritis, scleritis, and iritis. Some of these findings may be the clues for the diagnosis of the rheumatic diseases, and some ocular manifestations may represent the activity or prognosis of the rheumatic diseases. These ocular complications may leads to severe visual loss. It is crucial to rule out underlying systemic diagnosis in rheumatic disease associated ocular diseases, and when diagnosed, the coordination of the rheumatologist with the ophthalmologist in the treatment is imperative.
Corneal Ulcer ; Diagnosis ; Eye Diseases* ; Iritis ; Joints ; Pericardium ; Pleura ; Prognosis ; Rheumatic Diseases* ; Scleritis ; Sjogren's Syndrome