Background/Purpose: Ocular scleral pathology (OSP) includes episcleritis and scleritis. Episcleritis is generally a benign disease with a self-limited course, while scleritis is a more severe ocular condition. Both may be associated with immune-mediated inflammatory diseases (IMID).

In a wide series with OSP our aim was to assess the a) epidemiological and clinical features and b) relationship with IMID.

Methods: Study of all consecutive patients studied in a single Universitary Hospital during the last ten years with: a) episcleritis and b) scleritis diagnosed by clinical features and slit-lamp (Watson and Hayreh criteria).

Results: We studied 170 patients (101 women/ 69 men) / 340 affected eyes with OSP (episcleritis=132; scleritis=38); mean age at diagnosis 49.03±14.11 years.

OSP was unilateral in 138 (81.2%), recurrent in 70 (41.2%) and chronic in 21 (12.4%). Most of them were idiopathic (n=85, 50%) while associated IMID were 43.5% (TABLE 1).

Topical treatment was used in all patients. In addition to systemic corticosteroids, conventional immunosuppressive and biological drugs were required in 52 cases (30.6%) and 20 (11.8%), respectively (TABLE 2). The main indication for biological therapy was the presence of underlying IMID.

Conclusion: Scleral pathology is a relatively frequent entity and it is necessary to exclude an underlying systemic disease.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/ocular-scleral-pathology-and-immune-mediated-inflammatory-diseases-study-of-170-patients-from-a-single-universitary-center/