Infectious scleritis in Taiwan-a 10-year review in a tertiary-care hospital.

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

Cornea

journal_title

Cornea

authors

Ho YF,Yeh LK,Tan HY,Chen HC,Chen YF,Lin HC,Chen SY,Hui-Kang D,Hsiao CH

doi

10.1097/ICO.0000000000000174

subject

Has Abstract

pub_date

2014-08-01 00:00:00

pages

838-43

issue

8

eissn

0277-3740

issn

1536-4798

journal_volume

33

pub_type

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