Bilateral Posterior Scleritis: Analysis of 18 Cases from a Large Cohort of Posterior Scleritis

ABSTRACT

Purpose: To describe the clinical and epidemiological characteristics of patients and analyze factors associated with bilateral posterior scleritis.

Methods: In this retrospective cohort study, records of patients with diagnosis of bilateral posterior scleritis at two tertiary-care centers in the UK and India were analyzed in comparison with the clinical profile of patients with unilateral scleritis.

Results: In total, 18 patients with bilateral posterior scleritis were identified and compared with 96 patients of unilateral posterior scleritis; 14 (77%) were women and the median age was 48 years. Headache (p = 0.04), optic nerve swelling (p = 0.01), and elevated antinuclear antibodies (ANA) titers (p = 0.03) were present more frequently in patients with bilateral than in unilateral posterior scleritis. Seven patients (38.88%) required immunosuppressive therapy to attain resolution of the inflammation and to prevent relapse.

Conclusions: Bilateral posterior scleritis is an uncommon but severe inflammation of the posterior sclera. The majority of them are idiopathic, often requiring aggressive treatment to prevent visual loss.

• ANA
• bilateral posterior scleritis
• immunosuppressive therapy
• posterior scleritis
• systemic association

This work was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health.

DECLARATION OF INTEREST

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

FUNDING

This work was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health.

JJGL has received study grants from Alcon, Novartis and MSD, and has provided unpaid consultancy to Bayer. RA is on NMRC overseas research training fellowship at Institute of Ophthalmology and Moorfields Eye Hospital, London.