Epidemiology and Visual Outcomes in Patients With Infectious Scleritis

Adult Aged, 80 and over Male Adolescent Visual Acuity Middle Aged Prognosis Eye Infections, Bacterial 3. Good health 03 medical and health sciences Logistic Models 0302 clinical medicine Anti-Infective Agents Risk Factors Child, Preschool Florida Humans Female Child Eye Infections, Fungal Aged Retrospective Studies Scleritis
DOI: 10.1097/ico.0b013e318259c952 Publication Date: 2012-08-16T06:33:00Z
ABSTRACT
To describe the epidemiology of patients with infectious scleritis and identify factors associated with poor visual prognosis.Retrospective review of inciting factors, causative organisms, and visual outcomes of patients with infectious scleritis.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.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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