"Episcleritis"

Clinical implications of lowering episcleral venous pressure in the management of glaucoma and the use of Rho kinase inhibitors. There has been limited success in both measuring and modifying episcleral venous pressure (EVP) in clinical practice. Understanding the potential role of EVP in the management of glaucoma for different patients may allow for more individualized treatment approaches

Isolated ANCA-associated scleritis successfully treated with systemic rituximab; a case report and review of literature. Necrotizing scleritis is one of the most destructive ocular manifestations of underlying systemic diseases that can lead to a variety of severe complications, including globe perforation or vision loss. Necrotizing scleritis can occur in various conditions, such as systemic bilateral necrotizing scleritis with diffuse areas of necrosis, thinning of the sclera, and the choroidal show was observed which was impending perforation on both sides. Systemic medications, including intravenous methylprednisolone and cyclophosphamide, and topical medications were administered. However, due to an incomplete response to these drugs, intravenous rituximab was initiated. Significant

Preliminary Study on the Correlation Between Episcleral Venous Pressure and Intraocular Pressure in TAO Patients and Its Clinical Value. To study the correlation between episcleral vein pressure (EVP) with intraocular pressure (IOP), exophthalmos, and optic nerve injury in thyroid-associated ophthalmopathy (TAO) patients and to explore the possibility of higher EVP as an intervention indicator

Scleritis and development of immune-mediated disease: A retrospective chart review. Scleritis may be idiopathic or caused by trauma, infections, or an immune-mediated condition. Our study aimed to understand the relationship between scleritis and immune-mediated disease, including presenting characteristics, serologies, and treatment course. Understanding these associations may allow clinicians to risk-stratify patients and predict their clinical and treatment course. We conducted a retrospective chart review of 341 scleritis patients seen at a tertiary care center between January 1, 2005, and December 31, 2020. Demographics, scleritis characteristics, treatment response, recurrence, and serologic data were compared among patients with idiopathic and immune-mediated disease-associated

Management of Scleritis in Older Adults. Scleritis, an inflammatory disease of the eye affecting scleral tissue, presents unique challenges in the older adult population. Unlike their younger counterparts, older individuals manifest a distinct spectrum of the disease with different underlying etiologies, co-morbidities, altered immune function, and an increased risk of systemic side effects from

Scleritis in Systemic Sclerosis Treated With Infliximab Biosimilar. An 84-year-old woman diagnosed in 2002 with limited cutaneous systemic sclerosis (SSc) that is characterized by sclerodactyly, telangiectasia, Raynaud phenomenon, gastroesophageal reflux, and antinuclear antibodies, but negative for ScL70 and anticentromere antibody, presented with left eye redness and pain. Her gastroesophageal

False Passage of 5-0 Polypropylene Suture into Episcleral Vein during Gonioscopy Assisted Transluminal Trabeculotomy. Gonioscopy-assisted transluminal trabeculotomy (GATT) is a promising cost effective minimally invasive glaucoma surgery (MIGS). The main advantage being safety with regards to low risk for hypotony and its related complications. However, the Schlemm's canal (SC) based procedures is important not only for early identification but for prevention and management if they occur. Through this case report, we describe a rare complication where the suture had traversed through a dilated episcleral vein during GATT. To our knowledge, there has been no prior report of such a complication.

Acute bilateral nodular scleritis following strabismus surgery in a patient with Down syndrome. Scleritis is a rare complication of strabismus surgery. We present the case of an 11-year-old girl with Down syndrome who underwent strabismus surgery and developed bilateral symmetric nodular scleritis 3 weeks after surgery. Anterior segment optical coherence tomography revealed localized

Presumed tuberculosis-related scleritis. To evaluate the clinical characteristics and therapeutic outcome of patients with recurrent scleritis of unknown demonstrable aetiology and positive QuantiFERON-TB Gold In-Tube test (QFT). Retrospective chart review of the demographic, clinical, laboratory and therapeutic outcome data of 15 patients. Clinical characteristics as well as remission rate after standard antituberculous therapy (ATT) were assessed. There were 9 men and 6 women with a mean age of 48.9 years (range, 32-73). Scleritis was diffuse in 10 patients (66.6%) and nodular in 5 patients (33.3%), 1 of them with concomitant posterior scleritis. It was bilateral in 7 patients (46.6%) and recurrent in all of them. Scleritis appeared after prior uveitis (10 patients, 66.6

Scleral Proteome in Noninfectious Scleritis Unravels Upregulation of Filaggrin-2 and Signs of Neovascularization. Scleritis is a severe inflammatory ocular disorder with unknown pathogenesis. We investigated healthy sclera as well as sclera affected by noninfectious scleritis for differentially expressed proteins using a mass spectrometry approach. We collected scleral samples of enucleated eyes due to severe noninfectious scleritis (n = 3), and control scleral tissues (n = 5), all exenterated eyes for eyelid carcinomas (n = 4), or choroidal melanoma (n = 1) without scleral invasion. Samples were prepared for the nano liquid-chromatography mass spectrometer (LC-MS), data were analyzed using proteomics software (Scaffold), and is available via ProteomeXchange (identifier PXD038727). Samples

IgG4-related ophthalmic disease masquerading as ciliary body tumors and scleritis in both eyes: a case report. To report a rare case of IgG4-related ophthalmic disease (IgG4-ROD) manifesting as intraocular masses and scleritis in both eyes in a 61-year-old male and to investigate the changes in multimodal imaging features of the lesion sites and helper T-cell type 1 (Th 1)/Th 2/Th 17 cytokine levels in the aqueous humor. A patient with IgG4-ROD seemingly manifested with an intraocular tumor in the left eye and sequentially, with an inflammatory mass in the ciliary body and scleritis in the right eye. The patient complained of vision loss of 6 months duration in the left eye at his first visit. With a preliminary diagnosis of an intraocular tumor, enucleation of the left eyeball

Effectiveness of difluprednate in addition to systemic therapy for the treatment of anterior scleritis. To describe the effectiveness and side-effect profile of adding difluprednate therapy to patients with anterior scleritis being treated systemically. Retrospective chart review. Charts from all patients with anterior scleritis who were treated with topical difluprednate in addition to systemic therapy from 1 January 2018 to 1 January 2020 were reviewed. Data collected included: demographics, scleritis type, systemic diagnosis, presence of nodules or necrosis, changes in scleritis activity, intraocular pressure (IOP), number of difluprednate drops used, type of systemic treatment used, best-corrected visual acuity (BCVA) and lens status. The primary outcome was clinical resolution of scleritis

Alterations in choroidal circulatory dynamics and choroidal thickness before and after treatment in posterior scleritis. Posterior scleritis is an inflammatory reaction of the sclera that occurs posterior to the ora serrata. The aim of this study was to present a case of posterior scleritis and to analyze choroidal circulatory and structural changes using laser speckle flowgraphy (LSFG defects around the macula OU. Indocyanine green angiography showed mottled choroidal vascular hyperpermeability findings in the late stage. B-mode echography displayed thickening of the posterior wall of the left eye. Orbital magnetic resonance imaging showed the thickened posterior eyeball. The patient was diagnosed with posterior scleritis, and 30 mg of oral prednisolone was then given and tapered off

Acute-onset surgically induced necrotizing scleritis after strabismus surgery. Surgically induced necrotizing scleritis (SINS) is an uncommon but devastating complication that may occur days to years after ocular surgery. We report the case of a 32-year-old man who underwent uncomplicated strabismus surgery for large-angle exotropia and developed SINS characterized by painless scleral

of scleritis)(a) Non-necrotising (75% of all casesof anterior scleritis) * usually unilateral * hyperaemia of superficial and deep episcleral vessels; does not blanch with vasoconstrictors (e.g. gutt. phenylephrine 2.5%) * anterior uveitis may be present * tenderness of globe * When inflammation resolved, choroidal pigment may show through thinned sclera as a blue/black colouration * approximately 60 of a large cohort of patients with scleritis and episcleritis. Ophthalmology. 2012;119(1):43-50Sainz de la Maza M, Molina N, Gonzalez-Gonzalez LA, Doctor PP, Tauber J, Foster CS.Jabs DA, Scleritis therapy. Ophthalmology. 2012;119(1):51-8Thong LP, Rogers SL, Hart CT, Hall AJ, Lim LL. Epidemiology of episcleritis and scleritis in urban Australia. Clin Exp Ophthalmol. 2020;48(6):757-766Watson PG, Hayreh SS

of the Sclera in Patients with Scleritis and Episcleritis using Anterior Segment Optical Coherence Tomography. Ocul Immunol Inflamm. 2016;24(1):29-34Daniel Diaz J, Sobol EK, Gritz DC. Treatment and management of scleral disorders. Surv Ophthalmol. 2016;61(6):702-717Lloyd-Jones D, Tokarewicz A, Watson PG. Clinical evaluation of clobetasone butyrate eye drops in episcleritis. Br J Ophthalmol. 1981;65(9):641 -3Lyons CJ, Hakin KN, Watson PG. Topical flurbiprofen: an effective treatment for episcleritis? Eye (Lond). 1990;4(3):521-5Sainz de la Maza M, Molina N, Gonzalez-Gonzalez LA, Doctor PP, Tauber J, Foster CS. Clinical characteristics of a large cohort of patients with scleritis and episcleritis. Ophthalmology. 2012;119(1):43-50Salama A, Elsheikh A, Alweis, R. Is this a worrisome red eye? Episcleritis

Scleritis in Lyme Disease. To estimate the incidence of scleritis in Lyme disease and report clinical features. Incidence rate estimate and case series. Data were collected from an electronic medical record on patients with scleritis presenting to the Wilmer Eye Institute between January 1, 2012 and December 31, 2020. A diagnosis of Lyme disease was made using the Infectious Diseases Society of America, American Academy of Neurology, and the American College of Rheumatology 2020 joint criteria plus a response to antibiotic therapy. After identifying all new-onset cases of scleritis in the database, the proportion of new-onset scleritis with Lyme disease was calculated. The proportion of Lyme disease cases with scleritis was estimated using the number of cases with Lyme disease from

Adalimumab plus Conventional Therapy versus Conventional Therapy in Refractory Non-Infectious Scleritis. Long-term systemic glucocorticoids and non-specific immunosuppressants remain the mainstay of treatment for refractory scleritis, and result in serious side-effects and repeated inflammation flares. To assess the efficacy and safety of additional adalimumab, patients diagnosed with refractory non-infectious scleritis were enrolled. They were assigned to the conventional-therapy (CT, using systemic glucocorticoids and other immunosuppressants) group or the adalimumab-plus-conventional-therapy (ACT) group according to the treatments they received. The primary outcome was time to achieve sustained remission, assessed by a reduction in modified McCluskey's scleritis scores. Other outcomes

Effectiveness of Difluprednate for the Treatment of Anterior Scleritis. To describe the effectiveness and side effect profile of difluprednate therapy in a series of patients with anterior scleritis. Retrospective, interventional case series. Data collected from all patients with anterior scleritis who used difluprednate as a single treatment agent from January 1, 2018, to January 1, 2020 , including demographics, scleritis type, presence of nodules or necrosis, changes in scleritis activity, intraocular pressure (IOP), number of difluprednate drops used, best-corrected visual acuity (BCVA), and lens status. The primary outcome was clinical resolution of scleritis. Secondary outcomes included BCVA loss ≥2 lines, change in lens status or cataract surgery, and IOP ≥24 mm Hg. Twenty-five

Aqueous column changes in the episcleral veins after the instillation of ripasudil versus latanoprost: a randomized, double-blind, crossover clinical trial. To investigate whether the topical administration of ripasudil ophthalmic solution enhances aqueous outflow in the episcleral vein of the human eye. Two-sequence, prospective, randomized, double-blind, crossover trial. Sixteen eyes of 16 healthy participants were recruited in this study. Participants were randomized into one of the two crossover sequences to the instillation of ripasudil or the control drug, latanoprost, followed by a washout period of more than 2 days, and crossed over to the alternative instillation. The aqueous columns in the episcleral veins were recorded using a video capture system connected to a slit-light