Severity of episcleritis and systemic disease association.
OBJECTIVE
To analyze patient characteristics and correlate between the site and severity of the inflammation and ocular and/or systemic disease association in a cohort of patients with episcleritis.


METHODS
Retrospective case series.


METHODS
Medical records of 100 patients with episcleritis were reviewed. Data were analyzed using a customized database software.


RESULTS
The age range at presentation was 18 to 76 years (mean, 43; median, 44). Sixty-nine percent of the patients were female. Thirty-two (32%) patients had bilateral involvement. The episcleritis was nodular in 23 eyes (16%). Half of the patients had a concurrent eye disease. Associated systemic disease was found in 36 patients (36%). In two patients, episcleritis preceded a systemic vasculitic disease (Wegener granulomatosis and Cogan syndrome). Ocular complications included uveitis (11.4%), corneal involvement (15%), and glaucoma (7.8%). No significant correlation of the site and severity of inflammation to the presence of associated systemic or ocular diseases was found. The mean follow-up was 16.5 months. Twenty-eight patients experienced recurrence of episcleritis during the follow-up. Half of the patients required treatment with oral nonsteroidal anti-inflammatory drugs.


CONCLUSIONS
Episcleritis is usually a benign, self-limited disease, but it should not be trivialized since it may be associated with systemic disease and ocular complications. A careful review of systems should be performed in all patients presenting with episcleritis, and this should be repeated at least annually during the follow-up. A thorough eye examination is obviously essential to detect and treat ocular complications.
Akpek
E K
EK
Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston 02114, USA.
Uy
H S
HS
Christen
W
W
Gurdal
C
C
Foster
C S
CS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D015331:Cohort Studies; D005128:Eye Diseases / Q000150:complications; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D015423:Scleritis / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D012720:Severity of Illness Index; D014657:Vasculitis / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology
D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids