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Abstract Number: 2153

Ocular Scleral Pathology and Relationship with Autoimmune Diseases: Study of 101 Patients from a Single Universitary Centre

Lara Sanchez-Bilbao1, Iñigo Gonzalez-Mazon 2, Mónica Calderón-Goercke 3, DIANA PRIETO- PENA 2, Jose Luis Martín-Varillas 1, Belén Atienza-Mateo 1, Rosalia Demetrio 4, Miguel A Gonzalez-Gay 1 and Ricardo Blanco 1, 1Rheumatology, Hospital Universitario Marques de Valdecilla, Santander, Spain, 2Rheumatology, Hospital Universitario Marques de Valdecilla, Santander, Cantabria, Spain, 3Hospital Marqués de Valdecilla, Santander, Cantabria, Spain, 4Hospital Universitario Marqués de Valdecilla, Santander, Spain

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: ocular involvement and autoimmune diseases

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Session Information

Date: Tuesday, November 12, 2019

Session Title: Miscellanous Rheumatic & Inflammatory Disease Poster III: Autoimmune Conditions and Therapies

Session Type: Poster Session (Tuesday)

Session Time: 9:00AM-11:00AM

Background/Purpose: Ocular scleral pathology may be associated with autoimmune diseases. Our aim was to assess a) the epidemiological and clinical features and b) the relationship with immune-related diseases.

Methods: Observational study of unselected consecutive patients studied in a single reference University Hospital during the last ten years with: a) diagnosis of episcleritis and b) diagnosis of scleritis (Watson and Hayreh classification system, P. G. Watson, S. S. Hayreh, Br J Ophthalmol. 1976 Mar; 60(3): 163–191).
Patients were studied in a reference multidisciplinary unit (rheumatologist and ophthalmologist). Demographics features, clinical findings, complementary tests and treatment were recorded.

Results: We studied 101 (65 women/38 men) patients /202 eyes with diagnosis of scleral pathology (episcleritis=75; scleritis =26); mean age at diagnosis, 49.0±14.17 years. The mean follow-up was 3.68±5.30 years.Demographic baseline characteristics and clinical manifestations of these patients are shown in TABLE 1.
Diffuse anterior scleritis (n=17; 16.8%) was the most common type of scleritis, followed by nodular. In case of episcleritis, the most common was simple-form (n = 71; 70.3%).
Etiology was as follows: idiopathic (n=59, 58.4%), associated to systemic disease (SD-group) (n=32, 31.7%), and infectious (n=10, 9.9%). In SD-group, the main association was with Crohn’s disease (n=8; 7.9%), rheumatoid arthritis (n=6; 5.9%) and psoriatic arthritis (n=4; 3.9%).
Laboratory tests were also performed in all patients, mainly as screening of systemic diseases. Antinuclear antibodies (ANA) and rheumatoid factor (RF) were positive in 9 patients, followed by HLA-B27 7; 6.9%).
Attending to the treatment, 100% of patients received topical treatment as first-line therapy and 81.2% (n=81) NSAIDs. Another conventional immunosuppressor and biological treatment were required in 27.7% (n=28) and 6.9 (n=7) respectively. The main indication for biological therapy was the presence of concomitant systemic disease.
Some complications were reported, being keratitis (n=6; 5.9%) the most common.

Conclusion: The results obtained are reproducible to those published in international series, except a more frequent of Crohn’s disease and a less frequent of vasculitides. Scleral pathology is a frequent entity and it is necessary to exclude underlying systemic pathology.


Disclosure: L. Sanchez-Bilbao, None; I. Gonzalez-Mazon, None; M. Calderón-Goercke, None; D. PRIETO- PENA, None; J. Martín-Varillas, None; B. Atienza-Mateo, None; R. Demetrio, None; M. Gonzalez-Gay, Abbvie, 2, 5, 8, Celgene, 5, 8, Janssen, 2, MSD, 2, 5, 8, Pfizer, 5, 8, Roche, 2, 5, 8, Sanofi, 5, 8, Sobi, 5, 8; R. Blanco, None.

To cite this abstract in AMA style:

Sanchez-Bilbao L, Gonzalez-Mazon I, Calderón-Goercke M, PRIETO- PENA D, Martín-Varillas J, Atienza-Mateo B, Demetrio R, Gonzalez-Gay M, Blanco R. Ocular Scleral Pathology and Relationship with Autoimmune Diseases: Study of 101 Patients from a Single Universitary Centre [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/ocular-scleral-pathology-and-relationship-with-autoimmune-diseases-study-of-101-patients-from-a-single-universitary-centre/. Accessed April 11, 2021.
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