Acute anterior necrotizing scleritis: A case report

Gan, Yuen Keat; Ahmad, Syed Shoeb; Alexander, Sheena Mary; Samsudin, Amir

doi:10.1016/j.joad.2016.08.015

Cited by 2 publications

(3 citation statements)

References 6 publications

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“…Necrotizing scleritis is a rare and severe form with the highest proportion of underlying autoimmune conditions (85.7%), an older age of onset (> 45y/o) and the highest rate of complications, in contrast to other types of scleritis [7,8]. Autoimmune diseases, such as rheumatoid arthritis, granulomatosis with polyangiitis (GPA), relapsing polychondritis, SLE, and PsA, are the most commonly associated entities [7,9]. On the other hand, infectious causes are less common and are responsible for 5-10% of cases [10].…”

Section: Discussionmentioning

confidence: 99%

“…TB infections, which are endemic in the Philippines, were implicated in 4.2% of the cases in a study in an East Asian population [11]. Other infectious causes include HIV, herpes zoster, syphilis, Pseudomonas aeruginosa, Proteus, and Staphylococcus, with P. aeruginosa being the most common cause of infectious scleritis [7,8,9]. It has been suggested that the absence of an autoimmune pathology in necrotizing scleritis should alert the physician of a possible infectious etiology [7].…”

Section: Discussionmentioning

confidence: 99%

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Necrotizing Anterior Scleritis with kertouveitis in a Patient with Psoriasis: A Case Report

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Siazon,

Paz

2024

Preprint

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Objective: To present a rare case of necrotizing anterior scleritis with keratouveitis in a patient with psoriasis and to emphasize the importance of early recognition and aggressive systemic therapy to prevent its sequelae. Necrotizing anterior scleritis is a rare and severely debilitating condition in patients with psoriasis. We present the case of a 60-year-old man with a one-week onset of right eye redness, severe eye pain, and tenderness, accompanied by headache, photophobia, and foreign body sensation. The patient had a history of psoriasis for >20 years and was maintained on methotrexate and topical medications, with poor compliance. He was admitted two weeks prior due to COVID-19 infection. Examination of the right eye showed signs of anterior scleritis and kerato-uveitis. Autoimmune and infection screens yielded negative results. He was administered a regimen of topical cyclosporine BID, atropine TID, and oral prednisone at 1 mg/kg/day that was tapered accordingly after clinical response. Follow-up over the course of three weeks revealed decreased eye pain and improved visual acuity from 20/100 to 20/30 in the right eye. This case of necrotizing sclerotic sclerosis occurred in a setting of long-standing psoriasis and psoriatic arthritis with chronic methotrexate use and various environmental triggers. Early recognition and aggressive treatment with systemic and topical immunomodulators are required to prevent the sequelae of this disease.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Necrotizing Anterior Scleritis with kertouveitis in a Patient with Psoriasis: A Case Report

See,

Siazon,

Paz

2024

Preprint

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“…It is more commonly associated with the use of antimetabolites, for example, mitomycin C in pterygium surgery or trabeculectomy but has been reported after a variety of procedures, including cataract surgery, squint surgery, corneal grafting and vitrectomy 2–5. The condition is thought to arise due to an immune-complex hypersensitivity reaction towards an antigen that is either revealed or altered by ocular surgery 1 6–8. In a 1992 review of 52 eyes with SINS, mean time to onset was 9 months, though a small group developed the condition many years after squint surgery 9…”

Section: Discussionmentioning

confidence: 99%

Surgically-induced necrotising scleritis complicated byNocardiainfection following routine cataract surgery

Richardson-May

Chihaia²,

Rashid³

2022

BMJ Case Rep

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Necrotising scleritis is a rare, inflammatory condition with potentially devastating visual consequences. It can be associated with inflammatory and infectious causes, and has been linked to several different ocular procedures. We present a difficult case of a patient with surgically-induced necrotising scleritis following routine phacoemulsification cataract surgery, who developed a secondary Nocardia bacterial infection. He required a number of surgical interventions and prolonged antibiotic therapy, suffering recurrent scleral abscesses. A literature review accompanies our case report. Prompt recognition and adequate investigation for underlying inflammatory and infective causes are vital to maintain integrity of the globe and ensure suitable treatment of this challenging condition.

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Acute anterior necrotizing scleritis: A case report

Cited by 2 publications

References 6 publications

Necrotizing Anterior Scleritis with kertouveitis in a Patient with Psoriasis: A Case Report

Necrotizing Anterior Scleritis with kertouveitis in a Patient with Psoriasis: A Case Report

Surgically-induced necrotising scleritis complicated byNocardiainfection following routine cataract surgery

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