Esclerite: características clínicas, associação sistêmica, tratamento e evolução de 100 pacientes

Machado, Danuza de Oliveira; Curi, André Luis Land; Fernandes, Raphael Stehling; Bessa, Thais Fontes; Campos, Wesley Ribeiro; Oréfice, Fernando

doi:10.1590/s0004-27492009000200019

Cited by 5 publications

(7 citation statements)

References 16 publications

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“…Scleritis may represent a diagnostic challenge and is often associated with life-threatening systemic disease (in this series, only one patient had diabetes mellitus though) and vision-threatening ocular complications [15]. …”

Section: Discussionmentioning

confidence: 99%

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Clinico-Microbiological Profile and Treatment Outcome of Infectious Scleritis: Experience from a Tertiary Eye Care Center of India

Sahu

Das

Sharma

et al. 2012

International Journal of Inflammation

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Medical and microbiology records of seventeen patients (17 eyes), diagnosed as scleritis of infectious origin were reviewed; to study clinical features, predisposing risk factors, microbiologic profile and treatment outcome of infectious scleritis. The mean patient age was 52.3 ± 19.75 years. Twelve patients (70.6%) had history of trauma/prior surgery. Isolated organisms included Staphylococcus species (spp) (n = 5), Fungus (n = 4), Nocardia spp (n = 3), two each of atypical Mycobacterium spp and Streptococcus pneumoniae and one Pseudomonas aeruginosa. Treatment included intensive topical antimicrobial in all eyes and systemic medication in 15 (88.2%) patients; surgical exploration was needed for 13 (76.5%) patients and scleral patch graft was done in four (23.5%) patients. Lesions resolved in all patients and none required evisceration. The presenting log MAR visual acuity of 1.77 ± 1.40 and improved to 0.99 ± 0.91. (P ≤ 0.039) after treatment with a mean follow up of 22.57 ± 19.53 weeks. A microbiological confirmation, appropriate medical and/or surgical intervention has a good tectonic and visual outcome.

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Section: Discussionmentioning

confidence: 99%

“…P. aeruginosa has been the often reported infecting organism [10, 12, 13, 15]. It was reported in over 50% eyes from Taiwan following pterygium surgeries [12, 13].…”

Section: Discussionmentioning

confidence: 99%

Clinico-Microbiological Profile and Treatment Outcome of Infectious Scleritis: Experience from a Tertiary Eye Care Center of India

Sahu

Das

Sharma

et al. 2012

International Journal of Inflammation

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“…Embora a doença escleral seja rara, a esclerite anterior necrosante é extremamente grave, pois pode culminar com perda visual definitiva. Sendo assim, todos os esforços devem ser necessários para um diagnóstico rápido e correto dessa doença (MACHADO et al, 2009). A apresentação mais agressiva da esclerite aumenta o risco de associação sistêmica e de consequências graves para a função do olho (AKPEK et al, 2007).…”

Section: Relato De Casounclassified

Esclerite necrosante em paciente lúpica: relato de caso

Pontes¹,

Maneschy²,

Junior³

et al. 2019

Acervo Saúde

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Introdução: O lúpus eritematoso sistêmico (LES) é uma doença com elevado custo de tratamento, o qual está diretamente relacionado à gravidade do LES e, apesar dos esforços internacionais em pesquisas, permanece como agravo sem etiologia completamente definida, porém com fatores de risco e fisiopatologia cada vez mais elucidados. Episclerite e esclerite são vistas no LES e podem ser a característica da doença, e apesar de incomuns, podem ser os achados iniciais e preceder outras manifestações, sendo sua ocorrência usualmente indicativa de doença em atividade. Relato: Paciente do sexo feminino, 23 anos, procedente de sua residência, admitida na enfermaria com antecedente pessoal de LES há 6 anos, porém sem tratamento e com queixa de perda súbita da visão. Anteriormente à internação, a paciente apresentou febre, cefaléia, mal-estar geral e dor ocular intensa. Utilizou anti-inflamatório oral para alívio. Evoluiu com perda da visão, dor ocular e hiperemia com opacidade ocular central notada por familiares. Iniciou tratamento com prednisona e azatioprina, acompanhamento da reumatologia e oftalmologia. A principal hipótese diagnóstica foi esclerite necrosante, complicação do LES, devido perda visual súbita. Realizou pulsoterapia. Apesar da melhora clínica, permaneceu com diminuição da função visual. Durante a internação evoluiu com outras intercorrências. Recebeu alta, com diagnóstico de LES e esclerite necrosante e tratamento de manutenção. Conclusão: A esclerite necotizante anterior, embora rara, é extremamente grave pois pode levar a perda visual irreversível e, portanto, uma identificação e tratamento precoce são fundamentais para minimização de potenciais complicações.

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“…2,11,13,15 Topical steroids can be effective in milder forms of inflammation such as episcleritis but are usually not helpful in severe inflammation. In contrast to posterior or necrotising scleritis, non-necrotising diffuse scleritis may be mild and may not require oral corticosteroids or immunosuppression as the first line of therapy.…”

Section: Introductionmentioning

confidence: 99%

Flurbiprofen: A Nonselective Cyclooxygenase (COX) Inhibitor for Treatment of Noninfectious, Non-necrotizing Anterior Scleritis

Agrawal

Lee

González‐López

et al. 2015

Ocular Immunology and Inflammation

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Objective To analyse the safety and efficacy of a non-selective cyclo-oxygenase (COX) inhibitor in the management of non-infectious, non-necrotising anterior scleritis. Methods Retrospective chart review of 126 patients with non-necrotising anterior scleritis treated with oral flurbiprofen (Froben®(Abbott Healthcare)) with ( group B, n=61) or without topical steroids (group A, n=65) was performed and time to remission was plotted. Results The observed incidence rate was 1.07 (95% CI: 0.57–1.99) per 1000 person-years with failure rate of 0.68 (95% CI: 0.22–2.12) per 1000 person-years in group A and 1.41 (95% CI: 0.67–2.96) per 1000 person-years in group B. The failure rate was 3.97(1.89–9.34) per 1000 person-years with hazard ratio of 10.01 ( 95% CI: 2.52–39.65; p<0.001) for patients with associated systemic disease. Conclusion To our best knowledge, this is the first and largest case series on the safety and efficacy of a non-selective COX inhibitor in the management of anterior scleritis.

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Esclerite: características clínicas, associação sistêmica, tratamento e evolução de 100 pacientes

Cited by 5 publications

References 16 publications

Clinico-Microbiological Profile and Treatment Outcome of Infectious Scleritis: Experience from a Tertiary Eye Care Center of India

Clinico-Microbiological Profile and Treatment Outcome of Infectious Scleritis: Experience from a Tertiary Eye Care Center of India

Esclerite necrosante em paciente lúpica: relato de caso

Flurbiprofen: A Nonselective Cyclooxygenase (COX) Inhibitor for Treatment of Noninfectious, Non-necrotizing Anterior Scleritis

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