Clinical patterns and risk factors in scleritis: a multicentric study in Colombia Thesis

short description

  • Postgraduate thesis

Thesis author

  • Cabrera Pérez, Mariana
  • Cifuentes-Gomzález, Carlos
  • Cuevas, Miguel
  • Durán, Claudia
  • García, Sandra
  • Gómez Rocha, Alejandra
  • Gómez-Durán, Camilo Andrés
  • Martínez-Ceballos, María Alejandra
  • Mejía, María Elisa
  • Pachón-Suárez, Diana Isabel
  • Pérez, Yanny
  • Rangel, Carlos M
  • Reyes-Guanes, Juliana
  • Rojas-Carabali, William
  • de-la-Torre, Alejandra

external tutor

  • Cabrera Pérez, Mariana

abstract

  • Purpose This study aims to describe the clinical characteristics of scleritis in a large cohort of Colombian patients and identify factors associated with the clinical presentation. Methods Retrospective case series of patients with scleritis from 2015 to 2020. Clinical records were obtained from seven uveitis referral centers in Colombia. Patients with a diagnosis of episcleritis were excluded. Results We evaluated 389 patients with scleritis (509 eyes). There was a female predominance (75.6%) with a mean age of 51±15 years. Most cases were noninfectious (94.8%) and unilateral (69.2%). The most frequent type of inflammation was diffuse anterior scleritis (41.7%), followed by nodular scleritis (31.9%) and necrotizing scleritis (12.3%). Systemic autoimmune diseases were found in 41.3% of patients, the most common being rheumatoid arthritis (18.5%) and granulomatosis with polyangiitis (5.9%). Polyautoimmunity was found in 10.4% of those with a systemic autoimmune disease. The most frequent treatment was systemic steroids (50.9%), followed by systemic NSAIDs (32.4%). Steroid-sparing immunosuppression was required in 49.1% of patients. Systemic autoimmune diseases were more common in patients with necrotizing scleritis and those older than 40 years of age. Best-corrected visual acuity of 20/80 or worse at presentation was more common in necrotizing scleritis and subjects with associated uveitis, ocular hypertension, or who were over 40 years of age. Conclusions This is the frst study in Colombia and the largest in Latin America describing the clinical characteristics and presentation patterns of scleritis. The most common presentation was in females, with unilateral, anterior difuse noninfectious scleritis. Systemic autoimmune diseases and polyautoimmunity were frequent, as was the need for steroid-sparing immunosuppression. Age over 40 and necrotizing scleritis were associated with higher odds of having a systemic autoimmune disease and worse visual acuity at presentation.

publication date

  • February 14, 2023 2:57 PM

keywords

  • Autoimmunity
  • Epidemiology
  • Rheumatoid arthritis
  • Scleritis
  • Uveitis

Document Id

  • 252e2b5e-03c1-4cd5-9a27-0aa1d3fcf597