J Korean Ophthalmol Soc.  2019 Jun;60(6):510-518. 10.3341/jkos.2019.60.6.510.

Clinical Features and Treatment Outcomes in Patients with Infectious Scleritis

• Park MH
• Yoo WS
• Kim HA
• Chung I
• Seo SW
• Kim SJ

• KMID: 2449703
• DOI: http://doi.org/10.3341/jkos.2019.60.6.510

Abstract

PURPOSE
To investigate risk factors, clinical features, pathogenic organisms, and outcomes in patients with infectious scleritis.
METHODS
This study was a retrospective review of 20 patients with infectious scleritis who were admitted from January 2011 to December 2018 in a single tertiary hospital, with at least 3 months of follow-up. We analyzed age, risk factors, clinical manifestations, pathogenic organisms, treatment, and outcomes of infectious scleritis.
RESULTS
The mean patient age was 69.2 ± 8.4 years and the mean duration of hospitalization was 11.3 ± 5.8 days. Furthermore, the mean duration of symptoms before presentation was 16.8 ± 13.9 days; patients were followed for a mean duration of 23.3 ± 25.4 months. All patients had prior pterygium surgery. Eighteen patients (90%) were culture-positive and Pseudomonas aeruginosa (P. aeruginosa) was identified in 12 eyes. In the acute stages, adjuvant surgical intervention was performed for 18 patients (90%) for these patients, the mean duration of hospitalization before surgery was 4.1 ± 4.4 days.
CONCLUSIONS
The most common risk factor and pathogenic organism for infectious scleritis were prior pterygium surgery and P. aeruginosa, respectively. Identification of specific causative organisms and corresponding antibiotic treatment with adjuvant surgical intervention may improve visual prognosis in patients with infectious scleritis.

Keyword

Eye infections; Pseudomonas aeruginosa; Scleritis

MeSH Terms

Eye Infections
Follow-Up Studies
Hospitalization
Humans
Prognosis
Pseudomonas aeruginosa
Pterygium
Retrospective Studies
Risk Factors
Scleritis*
Tertiary Care Centers

Figure

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  Figure 1. Anterior segment photograph of patient with infectious scleritis before (A) and after (B) treatment. (A) Infectious scleritis caused by Pseudomonas aeruginosa developed at the previous pterygium excision area that presented with scleral necrosis. (B) Scleritis was resolved after treatment with intensive antibiotics and perichondrium graft with conjunctival flap.

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  Figure 2. Slit lamp photograph depicting Aspergillus flavus scleritis in a patient 10 years after pterygium surgery. (A) At the presentation showing scleral melting and abscess formation. (B) Fungus ball-like lesion were detected in the anterior chamber angle.

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  Figure 3. Anterior segment photo of a patient with infections scleritis. Seventy-year-old woman with fungal (Fusarium species) scleritis after pterygium excision. There was a severe scleral necrosis and adjacent corneal infiltration with satellite lesions.

Reference

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