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Browsing by Author "Vishwanathan, N. (59256015200)"

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    Publication
    Infectious Scleritis–Clinical Characteristics, Causative Factors, and Treatment Outcomes in an Indian Population
    (2025)
    Agarwal, Mamta (20833248100)
    ;
    Radosavljevic, Aleksandra (56993158000)
    ;
    Anand, A.R. (57211184166)
    ;
    Vishwanathan, N. (59256015200)
    ;
    Cunningham, Emmett T. (7101720969)
    Purpose: To study the clinical features, causative factors and treatment outcomes in patients with infectious scleritis seen in India. Methods: A retrospective study of all patients examined at a tertiary care center between August 2012 and March 2021. Results: Forty-five patients (45 eyes; mean age 52.7 ± 17.5 years) were included in the study. The mean duration of symptoms was 3.1 ± 4.4 months. Inciting factors were found in 53.3% (injury: 33.3%; ocular surgery: 20.0%). The scleritis was predominantly anterior (97.8%), with multiple lesions in 40.0%, a solitary lesion in 31.1%, and diffuse in 28.9%. Associated features included uveitis (51.1%), keratitis (37.8%), hypopyon (15.6%), and endophthalmitis (6.7%). Causative organisms included bacteria (53.3%), fungi (35.6%), and presumed herpes virus (11.1%). All patients were treated with antimicrobial agents along with systemic corticosteroids where indicated. Surgical treatment included scleral debridement (37.8%), patch grafts (4.4%), and penetrating keratoplasty (2.2%). Complete resolution of scleritis was seen in 86.7%, with a mean duration of therapy of 2.9 ± 2.5 months. The mean follow-up was 8.3 ± 14.3 months. 51.1% of patients lost functional vision (<6/60). Causes of decreased vision included corneal scar, cataract, macular scar, glaucomatous optic atrophy, and phthisis bulbi. On bivariate analysis, poor visual acuity at presentation was associated with a worse visual outcome (p = 0.02). Other risk factors included necrotizing scleritis, multifocal scleritis, the presence of keratitis and uveitis. Conclusion: In our study, infectious scleritis resulted from bacterial and fungal infections. The scleritis resolved in most subjects, however, vision loss was frequent due to infection-related complications. © 2024 Taylor & Francis Group, LLC.

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