Ocular characteristics and disease associations in scleritis-associated peripheral keratopathy.
OBJECTIVE
To evaluate ocular characteristics and systemic disease associations in patients with scleritis-associated peripheral keratopathy and its different patterns, and to assess any ocular or systemic prognostic significance of the presence of the types of peripheral keratopathy in patients with scleritis.


METHODS
Review of 125 patients with scleritis alone and 47 patients with scleritis-associated peripheral keratopathy; review of patients with scleritis and the different patterns of peripheral keratopathy: peripheral corneal thinning, stromal keratitis, and peripheral ulcerative keratitis (PUK); review of ocular and systemic outcomes comparisons between patients with scleritis with and without peripheral keratopathy.


RESULTS
Patients with peripheral keratopathy had more necrotizing scleritis (57%, P<.001), decrease in vision (81%, P<.001), anterior uveitis (62%, P<.002), impending corneal perforation (62%, P<.001), and potentially lethal specific-disease association (87%, P<.001) than did patients with scleritis alone. Patients with PUK had the worst ocular and systemic outcomes. Of the 24 patients with PUK, 16 (67%) had necrotizing scleritis (P =.02), virtually all had a potentially lethal systemic disease (P =.02), and all had impending corneal perforation (P<.001).


CONCLUSIONS
The detection of peripheral keratopathy, and especially PUK, in a patient with scleritis indicates a poor ocular and systemic prognosis.
Sainz de la Maza
Maite
M
Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles St, Boston, MA 02114, USA.
Foster
C Stephen
CS
Jabbur
Nada S
NS
Baltatzis
Stefanos
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003315:Cornea / Q000473:pathology; D003316:Corneal Diseases / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012422:Rupture, Spontaneous; D015423:Scleritis / Q000150:complications / Q000175:diagnosis*; D014606:Uveitis, Anterior / Q000175:diagnosis / Q000209:etiology