title: Infectious scleritis in Taiwan-a 10-year review in a tertiary-care hospital.
abstract: OBJECTIVE
  The aim of this study was to describe the clinical features of infectious scleritis with distinct inciting events and to analyze the factors associated with poor visual outcome.
  
  
  METHODS
  We retrospectively reviewed the predisposing factors, clinical findings, isolated organisms, complications, and outcomes of patients with infectious scleritis examined between January 2003 and December 2012 at the Chang Gung Memorial Hospital, Taiwan.
  
  
  RESULTS
  Forty-five (94%) of 48 patients with infectious scleritis had preceding inciting factors. Prior ocular surgery (40 eyes, 83%), especially pterygium excision (27 eyes, 57%), accounted for the majority of cases; prior accidental injury was found in 5 eyes (10%). The trauma group had a significantly shorter latency and duration of symptoms before diagnosis when compared with the surgery group. Pseudomonas aeruginosa (22 eyes, 46%) was the most commonly identified pathogen, and fungus was detected in 7 eyes (15%). Fungal infections had a longer symptom duration and smaller scleral ulcers at presentations than bacterial infections did. All patients were administered antimicrobials, and early surgical debridement (median 3 days) was performed in 38 eyes (79%). Three eyes (6%) required eyeball removal, and 10 patients (21%) had a posttreatment vision >20/200. With univariate analysis, the identified factors that were significantly associated with poor visual outcomes were visual acuity at presentation worse than 20/200 (P = 0.01), a long duration of hospitalization (P = 0.02), and eyes complicated by scleral thinning (P = 0.034).
  
  
  CONCLUSIONS
  Infectious scleritis associated with distinct inciting factors or different offending organisms can display divergent characteristics. Intensive antimicrobial treatment and early surgical debridement can salvage eyes.
authors: *Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan; and †College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors: Yeen-Fey
authors: YF
authors: Ho
authors: Lung-Kun
authors: LK
authors: Yeh
authors: Hsin-Yuan
authors: HY
authors: Tan
authors: Hung-Chi
authors: HC
authors: Chen
authors: Yeong-Fong
authors: YF
authors: Chen
authors: Hsin-Chiung
authors: HC
authors: Lin
authors: Shin-Yi
authors: SY
authors: Chen
authors: David
authors: D
authors: Hui-Kang
authors: Ching-Hsi
authors: CH
authors: Hsiao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001419:Bacteria / Q000302:isolation & purification; D001431:Bacteriological Techniques; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015423:Scleritis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D013624:Taiwan / Q000453:epidemiology; D062606:Tertiary Care Centers; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000890:Anti-Infective Agents