Abstract:
PURPOSE:The aim of this study was to describe the clinical features of infectious scleritis with distinct inciting events and to analyze the factors associated with poor visual outcome. METHODS:We retrospectively reviewed the predisposing factors, clinical findings, isolated organisms, complications, and outcomes of patients with infectious scleritis examined between January 2003 and December 2012 at the Chang Gung Memorial Hospital, Taiwan. RESULTS:Forty-five (94%) of 48 patients with infectious scleritis had preceding inciting factors. Prior ocular surgery (40 eyes, 83%), especially pterygium excision (27 eyes, 57%), accounted for the majority of cases; prior accidental injury was found in 5 eyes (10%). The trauma group had a significantly shorter latency and duration of symptoms before diagnosis when compared with the surgery group. Pseudomonas aeruginosa (22 eyes, 46%) was the most commonly identified pathogen, and fungus was detected in 7 eyes (15%). Fungal infections had a longer symptom duration and smaller scleral ulcers at presentations than bacterial infections did. All patients were administered antimicrobials, and early surgical debridement (median 3 days) was performed in 38 eyes (79%). Three eyes (6%) required eyeball removal, and 10 patients (21%) had a posttreatment vision >20/200. With univariate analysis, the identified factors that were significantly associated with poor visual outcomes were visual acuity at presentation worse than 20/200 (P = 0.01), a long duration of hospitalization (P = 0.02), and eyes complicated by scleral thinning (P = 0.034). CONCLUSIONS:Infectious scleritis associated with distinct inciting factors or different offending organisms can display divergent characteristics. Intensive antimicrobial treatment and early surgical debridement can salvage eyes.
journal_name
Corneajournal_title
Corneaauthors
Ho YF,Yeh LK,Tan HY,Chen HC,Chen YF,Lin HC,Chen SY,Hui-Kang D,Hsiao CHdoi
10.1097/ICO.0000000000000174subject
Has Abstractpub_date
2014-08-01 00:00:00pages
838-43issue
8eissn
0277-3740issn
1536-4798journal_volume
33pub_type
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