title: Clinical features, predisposing factors, and treatment outcomes of scleritis in the Korean population.
abstract: OBJECTIVE
  To evaluate the clinical features, associated factors, and treatment outcomes of scleritis in the Korean population.
  
  
  METHODS
  Medical records were retrospectively reviewed for 94 eyes of 76 patients with scleritis. Clinical features of scleritis, including systemic disease, presence of microorganisms, serologic markers, history of previous ocular surgery, and use of immunosuppressants were investigated and compared amongst the subtypes of scleritis. Treatment outcomes were evaluated using best corrected visual acuity (BCVA) and time to scleritis remission.
  
  
  RESULTS
  Nodular scleritis was the most common form observed, followed by necrotizing scleritis with inflammation, diffuse scleritis, and necrotizing scleritis without inflammation, respectively. A total of 16 of 76 patients (21.1%) had connective tissue diseases. Eleven cases (14.5%) had infectious scleritis, of which bacteria (54.5%) and fungi (45.5%) were the causative microorganisms. Thirty-three patients (43.4%) had previous ocular surgery, mostly pterygium excision. Notably, a history of pterygium excision was significantly associated with development of necrotizing and infectious scleritis (odds ratio [OR], 399 and 10.1; p < 0.001 and 0.002, respectively). In addition, patients with necrotizing scleritis were more likely to have infectious scleritis (OR, 11.7; p = 0.001). BCVA after treatment and time to remission also showed significant differences among the different scleritis subtypes. Systemic immunosuppression was required in addition to steroids for treating diffuse and necrotizing scleritis.
  
  
  CONCLUSIONS
  Careful taking of patient history including previous pterygium excision should be performed, especially in patients with necrotizing and infectious scleritis. In addition, evaluation of microbiological infection can be crucial for patients with necrotizing scleritis and history of pterygium excision.
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Seong Joon
authors.initials: SJ
authors.lastname: Ahn
authors.forename: Joo Youn
authors.initials: JY
authors.lastname: Oh
authors.forename: Mee Kum
authors.initials: MK
authors.lastname: Kim
authors.forename: Jin Hak
authors.initials: JH
authors.lastname: Lee
authors.forename: Won Ryang
authors.initials: WR
authors.lastname: Wee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001424:Bacterial Infections; D002648:Child; D005139:Eyeglasses; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009181:Mycoses; D011184:Postoperative Period; D011625:Pterygium / Q000601:surgery; D012189:Retrospective Studies; D015423:Scleritis / Q000145:classification / Q000208:ethnology / Q000209:etiology* / Q000601:surgery*; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult