title: Posterior Scleritis: Analysis of Epidemiology, Clinical Factors, and Risk of Recurrence in a Cohort of 114 Patients.
abstract: OBJECTIVE
  To describe the clinical and epidemiological characteristics of patients with posterior scleritis, and to analyze the response to treatment and time to relapse.
  
  
  METHODS
  Retrospective study of 114 cases of posterior scleritis from two tertiary care, university-affiliated, referral centers in the United Kingdom and India between 2004 and 2013. Data included sociodemographic factors, medical history, clinical, laboratory and ultrasound findings, therapies, and outcomes. LogMAR visual acuity at presentation and final visit and time to relapse were the main outcome measures.
  
  
  RESULTS
  The mean age was 45.9 ± 16.8 years, 71.1% were women, and 18 (15.8%) patients had bilateral disease; 71 (62.3%) cases were idiopathic. Rheumatoid polyarthritis (12.28%), systemic lupus erythematous (4.38%) and pANCA(+) systemic vasculitis (5.26%) were the most frequent systemic associations. VA improved by 0.24 ± 0.36 LogMAR between presentation and last follow up (p < 0.001). The median time to remission was 210 days (95% CI: 184-256 days). Recurrences after remission were observed in 36.63%. The observed incidence rate of posterior scleritis relapse after remission was 15.81% per person-year (95% CI: 11.78-20.77%). Systemic disease was present significantly in patients more than 50 years of age (OR = 2.29; 95% CI: 1.01-5.17; p = 0.044).
  
  
  CONCLUSIONS
  Posterior scleritis is an uncommon disease causing pain and visual loss. In around 40% of the cases, it can be associated with other systemic diseases. Median time to relapse was 210 days. Relapses may occur in around 1 in 3 patients, with an incidence rate of 15.81% per person/year.
authors.affiliation: a Moorfields Eye Hospital, NHS Foundation Trust , London , UK .
authors.forename: Alenka
authors.initials: A
authors.lastname: Lavric
authors.affiliation: a Moorfields Eye Hospital, NHS Foundation Trust , London , UK .|b Surgery Department , Universidad de Alcalá School of Medicine , Madrid , Spain .
authors.forename: Julio J
authors.initials: JJ
authors.lastname: Gonzalez-Lopez
authors.affiliation: c Medical Research Foundation , Chennai , India .
authors.forename: Parthopratim Dutta
authors.initials: PD
authors.lastname: Majumder
authors.affiliation: c Medical Research Foundation , Chennai , India .
authors.forename: Nishat
authors.initials: N
authors.lastname: Bansal
authors.affiliation: c Medical Research Foundation , Chennai , India .
authors.forename: Jyotirmay
authors.initials: J
authors.lastname: Biswas
authors.affiliation: a Moorfields Eye Hospital, NHS Foundation Trust , London , UK .|d Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology , London , UK , and.
authors.forename: Carlos
authors.initials: C
authors.lastname: Pavesio
authors.affiliation: a Moorfields Eye Hospital, NHS Foundation Trust , London , UK .|e National Healthcare Group Eye Institute, Tan Tock Seng Hospital , Singapore.
authors.forename: Rupesh
authors.initials: R
authors.lastname: Agrawal
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000453:epidemiology; D015862:Choroid Diseases; D058447:Eye Pain / Q000175:diagnosis; D005260:Female; D006261:Headache / Q000175:diagnosis; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D057972:Posterior Eye Segment / Q000473:pathology*; D012008:Recurrence; D012163:Retinal Detachment / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D015423:Scleritis / Q000175:diagnosis / Q000453:epidemiology*; D013167:Spondylitis, Ankylosing / Q000453:epidemiology; D062606:Tertiary Care Centers; D014792:Visual Acuity
keywords: Ankylosing spondylitis; immunosuprression; posterior scleritis; rheumatoid arthritis; scleral disease; scleritis; systemic disease; “T” sign