Date of Award
Open Access Thesis
Medical Doctor (MD)
Scleritis is a highly symptomatic inflammatory disease of the sclera. We conducted a retrospective study to identify demographic factors and comorbidities associated with resolution of scleritis, to compare patient outcomes on different treatments for scleritis, and to compare treatment utilization by the different medical specialties that manage scleritis. The medical records of all patients with a CPT code for scleritis seen at a tertiary care center from January 1, 2013 to January 1, 2020 were reviewed. Data was collected on demographic factors, comorbidities, and treatment. The primary outcome measures were time until resolution of disease, defined as quiescence of inflammation on two or more sequential visits, and time until resolution on steroid-sparing therapy, defined as being on 10 milligrams or less of prednisone without a recurrence of inflammation on two sequential visits. The study was approved by the Yale School of Medicine Institutional Review Board (IRB). We identified in 256 patients (302 eyes) with scleritis, including 232 patients (90.6%) with diffuse anterior scleritis, 10 patients (3.9%) with nodular anterior scleritis, two patients (0.8%) with necrotizing scleritis with inflammation, and three patients (1.2%) necrotizing scleritis without inflammation (scleromalacia perforans). The most commonly used therapies were topical steroids (44.9%), systemic NSAIDs (34%), and systemic steroids (34%). Non-corticosteroid immunomodulatory therapies (IMTs) were required in 39.5% of patients, most commonly methotrexate (17.2%) and TNF-⍺ inhibitors (9.1%). Scleritis was associated with a systemic autoimmune disease in 90 patients (35.2%). These patients were more likely to receive systemic corticosteroids and non-corticosteroid IMTs (p
Abdel-Aty, Ahmad, "A Comprehensive Study Of Comorbidities And Treatments Including Tnf-⍺ Inhibitors In Patients With Acute Scleritis" (2021). Yale Medicine Thesis Digital Library. 3976.
This Article is Open Access