title: Diagnosis and management of non-infectious immune-mediated scleritis: current status and future prospects.
abstract: Scleritis is an inflammatory process of the sclera and adjacent tissues with a wide spectrum of clinical presentations and co-morbidities. Careful clinical history taking, detailed ocular examination, and appropriate investigation for likelihood of an underlying systemic disease are essential for diagnosis. Treatment can be quite challenging in some cases. Conventional therapy with corticosteroids and immunosuppressive agents may not be sufficient to control ocular inflammation in refractory patients. In such cases new therapeutic agents, which have a more targeted and sustained effect on the immune response, so-called biologic response modifiers, are being used. This review focuses on both diagnosis and therapeutic options including traditional and emerging therapies of non-infectious scleritis.
authors.affiliation: a Istanbul Faculty of Medicine, Department of Ophthalmology , Istanbul University , Istanbul , Turkey.|b Massachusetts Eye Research and Surgery Institution (MERSI) , Waltham , MA , USA.|c Ocular Immunology and Uveitis Foundation , Waltham , MA , USA.
authors.forename: Merih
authors.initials: M
authors.lastname: Oray
authors.affiliation: b Massachusetts Eye Research and Surgery Institution (MERSI) , Waltham , MA , USA.|c Ocular Immunology and Uveitis Foundation , Waltham , MA , USA.
authors.forename: Halea
authors.initials: H
authors.lastname: Meese
authors.affiliation: b Massachusetts Eye Research and Surgery Institution (MERSI) , Waltham , MA , USA.|c Ocular Immunology and Uveitis Foundation , Waltham , MA , USA.|d Department of Ophthalmology , Harvard Medical School , Boston , MA , USA.
authors.forename: C Stephen
authors.initials: CS
authors.lastname: Foster
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000628:therapy; D003937:Diagnosis, Differential; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007167:Immunotherapy / Q000379:methods*; D033401:Microscopy, Acoustic; D012590:Sclera / Q000000981:diagnostic imaging* / Q000276:immunology; D015423:Scleritis / Q000175:diagnosis* / Q000628:therapy; D041623:Tomography, Optical Coherence; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology
chemical_list: D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha
keywords: Scleritis; alkylating agents; anti-metabolites; biologic agents; diagnosis; therapy