Determinants of Clinical Outcomes After Infectious Scleritis
Glenn J. Oh, Ashley Khalili, Kristin M. Hammersmith, Parveen K. Nagra, Christopher J. Rapuano, Zeba A. Syed- Ophthalmology
Purpose:
The aims of this study were to describe the clinical course of microbial infectious scleritis and identify factors associated with poor visual outcomes.
Methods:
Data from 26 eyes of 26 patients with culture-proven bacterial or fungal scleritis presenting at a single tertiary center from January 1, 2007, to July 1, 2021, were reviewed. Thirty-six variables were analyzed for associations with poor vision [best-corrected visual acuity (BCVA) <20/200] or loss of vision (no light perception vision or requirement for enucleation or evisceration) at final visit.
Results:
The mean age at initial presentation was 67.1 ± 14.0 (range: 34–92) years with a mean follow-up of 2.1 ± 2.2 (0.05–8.45) years. The mean presenting logarithm of minimal angle of resolution (logMAR) BCVA was 1.3 ± 1.0 (∼20/400) and mean final logMAR BCVA was 1.6 ± 1.2 (∼20/800). Fourteen eyes (53.8%) exhibited poor vision and 7 (26.9%) had loss of vision at final follow-up. History of necrotizing scleritis and poor presenting vision were associated with poor final vision (OR = 19.1;
Conclusions:
Infectious scleritis is often successfully treated, but loss of vision or eye removal is common. Poor baseline vision, history of necrotizing scleritis, and fungal etiology were prognostic for worse clinical outcomes. Surgical intervention was associated with quicker resolution compared with medical treatment alone.