No abstract available.
Hyperplasia* ; Scleritis*

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*

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

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 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 report the effectiveness of an autologous tragal perichondrium graft for a necrotizing scleritis case which was refractory to conventional surgery. CASE SUMMARY: A 75-year-old woman was referred to our clinic with recurrent necrotizing scleritis of the left eye which occurred after pterygium removal five years earlier. The patient underwent scleral graft, pericardium graft, and amniotic membrane graft in other clinics; however, necrosis of the sclera progressed. The best corrected visual acuity was 0.06, and choroidal tissue was nearly exposed below the melted pericardium graft in the nasal area. The authors harvested tragal perichondrium from the right ear, and the scleral defect was successfully reconstructed with an autologous tragal perichondium graft. The graft showed rapid epithelization and neovascularization within a week and conjunctivalization after three months. No complications have been observed up to one year after surgery. CONCLUSIONS: Autologous tragal perichondrium graft is an effective treatment to alter necrotized sclera via neovascularization and rapid epithelization in refractory necrotizing scleritis cases.
Aged ; Amnion ; Choroid ; Ear ; Eye ; Female ; Humans ; Necrosis ; Pericardium ; Pterygium ; Sclera ; Scleritis ; Transplants ; Visual Acuity

Plasmin is an enzyme which plays an important role in the inflammatory process by activating vasoactive amine and lysis of fibrin. On the other hand, plasmin is also known to activate latent collagenase. Plasmin is an activated form of plasminogen which is stimulated by the plasminogen activator that exists in plasma and tissue. Gordon et al(1980) insisted that collagenase is important to the formation of corneal ulcer because it destroys the collagen which is the main component of the cornea. Berman et al(1980) reported that corneal tissue destruction by plasminogen activator-plasmin system can be a cause of corneal ulcer. We could obtain the following results by checking the plasmin activity in the tear of chronic corneal ulcer patients and necrotizing scleritis patients. 1. The plasmin activity in the tear was increased in all three chronic corneal ulcer patients in concentration of 1/16 sigma unit/ml to 1/8 sigma unit/ml. 2. There was no plasmin activity in the tear of the two necrotizing scleritis patients.
Collagen ; Collagenases ; Cornea ; Corneal Ulcer* ; Fibrin ; Fibrinolysin* ; Hand ; Humans ; Plasma ; Plasminogen ; Plasminogen Activators ; Scleritis ; Tears*

PURPOSE: We report a case of orbital pseudotumor developed in an anophthalmic socket, presenting no typical symptoms or signs. METHODS: A 67-year-old woman was referred for treatment of necrotizing scleritis of her left eye and painful orbital pseudotumor of her right eye. The right eye had been removed 10 years previously. There was an irregular mass in superomedial portion of anterior orbit. Orbital MRI showed poorly defined T1 iso and low T2 signal intensity of a lesion in the medial anterior portion of the right orbit. Because systemic steroid administration was limited, 2 mg of betamethasone was injected locally, after which the size of the lesion was decreased and the orbital pain improved. CONCLUSIONS: The diagnosis of an orbital pseudotumor developed in an anophthalmic socket may be difficult because of the lack of typical eyeball-related signs or symptoms such as proptosis, red eye, or decreased vision. But, the easy access to the lesion can provide early and effective treatment through direct injection of glucocorticoid.
Aged ; Anophthalmos* ; Betamethasone ; Diagnosis ; Exophthalmos ; Female ; Humans ; Inflammation* ; Magnetic Resonance Imaging ; Orbit* ; Orbital Pseudotumor ; Scleritis

PURPOSE: To evaluate the ocular manifestations of patients with rheumatic disease and dry eye symptom. METHODS: We analized the results of ocular examinations and complications of 78 rheumatoid disease patients who were refered for dry eye symptom from the general medicine from 1998, May to 1999, May. RESULTS: Ocular complications were seen in 47 patients (60.3%). Keratoconjunctivitis sicca was the most common ocular finding (48.7%). Other lesions were episcleritis, scleritis, peripheral corneal erosion, marginal keratitis, stromal corneal opacity, and so on. Thirty six patients (46.2%) showed sero-positivity for RA, ANA or CRP. The result was 6.87+/-4.44 mm (mean+/-standard deviation) in Schirmer test,6.64+/-2.27 sec in Tear Film Break Up Time (TBUT). Among sero-positive patients, Schirmer test was 5.46+/-4.05 mm and TBUT was 5.64+/-2.38 sec, while among sero-negatives the result was 8.21+/-4.33 mm, 7.40+/-1.89 sec respectively. It was statistically significant (P< 0.05). Schirmer test was 4.60+/-3.55 mm in RA positive, 2.50+/-1.60 mm in RA and ANA positive, 7.35+/-4.92 mm in CRP positive. TBUT was 5.57+/-2.39 sec, 4.00+/-1.31 sec, 5.69+/-2.04 sec in each group. CONCLUSIONS: Ocular complications were increased in rheumatoid patients, especially with sero-positive for RA, ANA or CRP. The results of Schirmer test and TBUT were most decreased in patients with RA and ANA positivity.
Corneal Opacity ; Humans ; Keratitis ; Keratoconjunctivitis Sicca ; Rheumatic Diseases* ; Rheumatoid Factor ; Scleritis ; Tears

Methotrexate (MTX) is an antimetabolite which interferes with DNA synthesis, and it is used for the treatment of moderate to severe psoriasis, atopic dermatitis and a wide variety of cutaneous diseases. Although many adverse effects of MTX, including cutaneous ulcerations, have been documented, multifocal mucosal ulceration mimicking Behcet's disease has not been reported. In our case, a 63-year-old female presented with oral, vaginal ulcer and multiple purpuric patches on both legs. Considering patient's clinical course and histopathologic findings, we presumed that these reactions may be the side effect of MTX administered for treatment of necrotizing scleritis. Herein we report the cutaneous side effect of MTX that manifested clinically like Behcet's disease.
Dermatitis, Atopic ; DNA ; Female ; Humans ; Leg ; Methotrexate ; Middle Aged ; Psoriasis ; Scleritis ; Ulcer