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41. Necrobiotic xanthogranuloma scleritis in a case of granulomatosis with polyangiitis (Wegener’s granulomatosis) Full Text available with Trip Pro

Necrobiotic xanthogranuloma scleritis in a case of granulomatosis with polyangiitis (Wegener’s granulomatosis) The purpose of this study was to describe a case of necrobiotic xanthogranuloma scleritis in a 53-year-old male with unilateral progressive visual loss, scleritis, prolonged fever, and multiple mononeuropathy. Scleral biopsy showed necrosis with small abscess, and the pathological tissues revealed submucosal infiltration of mononucleated foamy histiocytes (xanthoma cells (...) and later with intravenous cyclophosphamide monthly. He responded well to treatment, both eye and systemic conditions. Necrobiotic xanthogranuloma scleritis could be an early presentation of granulomatosis with polyangiitis.

2017 International medical case reports journal

42. Systemic Cyclosporine Therapy for Scleritis: A Proposal of a Novel System to Assess the Activity of Scleritis Full Text available with Trip Pro

Systemic Cyclosporine Therapy for Scleritis: A Proposal of a Novel System to Assess the Activity of Scleritis In the present study, two female patients with unilateral scleritis without systemic complications were examined. Both patients were suffering from ocular pain and received corticosteroid therapy. The first patient, a 45-year-old woman, was diagnosed with scleritis and iritis in her right eye. Topical corticosteroid treatment could eradicate the iritis but not the scleritis. Oral (...) corticosteroid administration and corticosteroid pulse therapy were applied with little effect. The application of systemic cyclosporine had a satisfactory effect in controlling the scleritis. The other patient, a 60-year-old woman, was suffering from scleritis and lid swelling in her right eye. Not only did topical and systemic corticosteroid therapy prove insufficient, they also resulted in the elevation of her intraocular pressure. After termination of corticosteroid therapy, the systemic cyclosporine

2015 Case reports in ophthalmology

43. Scleritis

Scleritis Scleritis Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Scleritis Scleritis Aka: Scleritis , Nodular Scleritis (...) , Necrotizing Scleritis From Related Chapters II. Epidemiology Rare III. Pathophysiology Severe l inflammation Variations Nodular Scleritis Necrotizing Scleritis (most destructive) Anterior Scleritis (deep to ) Posterior Scleritis (overlying ) IV. Causes Idiopathic in 50% of cases (most common cause) Accounts for up to one third of Scleritis cases Scleritis occurs in 4-10% of RA cases (previously known as ) Infectious (uncommon) Pseudomonas V. Symptoms involving one or both eyes Blurred vision Photophobia

2018 FP Notebook

44. Poststreptococcal syndrome presenting as posterior scleritis in a child. (Abstract)

Poststreptococcal syndrome presenting as posterior scleritis in a child. Posterior scleritis in children is very rare. In contrast to the adult form, pediatric posterior scleritis has not previously been associated with any systemic disorder. We describe a case of an 11-year-old girl who presented with left eye pain and redness and was found to have posterior scleritis on ultrasonography. Her laboratory work-up revealed a highly elevated antistreptolysin O titer; the rest of her serologic (...) and radiologic evaluation was unremarkable. She was diagnosed with presumed poststreptococcal posterior scleritis and improved with a slow taper of oral steroids.Copyright © 2016 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

2016 JAAPOS - Journal of the American Association for Pediatric Ophthalmology and Strabismus

45. Rituximab in the Treatment of Refractory Non-Infectious Scleritis. (Abstract)

Rituximab in the Treatment of Refractory Non-Infectious Scleritis. To describe the outcomes of the use of rituximab in the treatment of refractory noninfectious scleritis.Retrospective case series.Review of the medical charts of patients with noninfectious scleritis refractory to conventional immunomodulatory therapy who were seen at the Massachusetts Eye Research and Surgery Institution between 2005 and 2015. The primary outcome measure in this study was steroid-free remission. Secondary (...) outcomes were favorable response (decrease in scleritis activity score) and decrease in steroid dependence.There were 15 patients, with a mean follow-up duration of 34 months. Fourteen patients (93.3%) showed a clinical improvement, with 13 (86.6%) achieving a scleritis activity score of zero at 6 months. To date, 2 patients continue to enjoy durable drug-free remission (28 and 32 months follow-up). There was only 1 adverse effect recorded (infusion hypotension) requiring cessation

2016 American Journal of Ophthalmology

46. Intravitreal dexamethasone implants for the treatment of refractory scleritis combined with uveitis in adult-onset Still's disease: a case report. Full Text available with Trip Pro

Intravitreal dexamethasone implants for the treatment of refractory scleritis combined with uveitis in adult-onset Still's disease: a case report. Adult-onset Still's disease is a systemic inflammatory disease which presents with uveitis and scleritis in the eye. Intravitreal dexamethasone implants are used for the treatment of refractory uveitis.A 19-year-old woman diagnosed to have adult-onset Still's disease for fevers, joint pain, and a salmon-colored bumpy rash presented with scleritis (...) and uveitis in the left eye. Topical and systemic steroids with oral methotrexate failed to control the inflammation. We performed intravitreal injections of dexamethasone implants for side effects of steroid and refractory ocular inflammation. The therapy resulted in improvements in the patient's uveitis with reductions in scleral vessel engorgement and redness. There was no recurrence of uveitis or scleritis during 4 months following treatment.Intravitreal injections of dexamethasone implants may result

2016 BMC Ophthalmology

47. Trabecular Micro-Bypass Stent Use in Necrotizing Scleritis. (Abstract)

Trabecular Micro-Bypass Stent Use in Necrotizing Scleritis. In this case report, we describe the successful implantation of multiple trabecular micro-bypass iStents in a patient with necrotizing scleritis.The study design is a case report.The participant was a patient who underwent multiple micro-bypass iStent surgery.A 71-year-old man with primary open-angle glaucoma, diagnosed with necrotizing scleritis and treated with steroids consequently resulting in significantly elevated intraocular (...) pressure in the right eye.Following uncomplicated surgery, IOP was reduced from 42 to 12 mm Hg 18 months after surgery on 2 drops and prednisone 40 mg daily CONCLUSIONS:: iStents may be considered as a possible intervention to lower IOP in patients with necrotizing scleritis in whom traditional glaucoma surgery is challenging or contraindicated.

2016 Journal of Glaucoma

48. Gevokizumab in the treatment of autoimmune, non-necrotizing, anterior scleritis: Results of a phase I/II clinical trial. Full Text available with Trip Pro

Gevokizumab in the treatment of autoimmune, non-necrotizing, anterior scleritis: Results of a phase I/II clinical trial. To evaluate the safety and potential efficacy of gevokizumab, an anti-interleukin 1β (IL-1β) monoclonal antibody, in the treatment of active, noninfectious, non-necrotizing anterior scleritis.Phase 1/2, open label, nonrandomized, prospective, single-arm pilot trial.Eight patients with active, noninfectious, non-necrotizing anterior scleritis with a scleral inflammatory grade (...) scleritis grading system by 16 weeks in the study eye compared to baseline. Secondary outcomes included changes in visual acuity, intraocular pressure, and trends in scleral grading. Participants who met the primary outcome were eligible to continue in the study for up to 52 weeks and received additional gevokizumab injections every 4 weeks until week 36, followed by 2 safety visits at weeks 40 and 52.Seven eyes from 7 patients met the primary outcome within a median time of 2 weeks following the first

2016 American Journal of Ophthalmology

49. Ocular toxocariasis presenting as bilateral scleritis with suspect retinal granuloma in the nerve fiber layer: a case report. Full Text available with Trip Pro

Ocular toxocariasis presenting as bilateral scleritis with suspect retinal granuloma in the nerve fiber layer: a case report. This report details ocular toxocariasis presenting as bilateral scleritis with suspect retinal granuloma in the nerve fiber layer.The patient presented with scleritis, which did not improve with systemic steroid. Intraocular pressure was elevated, and well demarcated hyper-reflective round lesion were noted in both eyes. He had a history of general ache and concurrent (...) onset of ocular symptoms the day after eating raw meat. Systemic work-ups revealed no remarkable abnormalities except antibody for toxocara. Oral albendazole and steroid were prescribed. The inflammation and swellings resolved without recurrence. In the current case, scleritis with suspect granuloma in the nerve fiber layer seems to be caused by toxocara.Ocular toxocariasis can be presented as atypical features. Serologic exams for toxocariasis would be considered not only in typical features

2016 BMC Infectious Diseases

50. Interleukin-22 serum levels are elevated in active scleritis. (Abstract)

Interleukin-22 serum levels are elevated in active scleritis. To evaluate serum cytokine profile from patients with active scleritis in a two-centre prospective case-control study.The serum of 20 active scleritis patients not treated with any local, periocular, or systemic immunomodulatory therapy (IMT) was analysed with multiplex assay to determine the levels of 11 cytokines interleukin (IL)-1β, IL-6, IL-2, IFN-γ, IL-10, IL-12p40, IL-13, IL-17A, IL-5, TNF-α, and TNF-β, and with ELISA (...) to determine the levels of TGF-β1, IL-22, and IL-23. Twenty-five age-matched healthy volunteers were used as controls. In a subgroup of 13 patients with active disease, a second serum sample was obtained when the disease was inactive and levels of IL-22 were determined. Serum IL-22 levels from patients with active scleritis were correlated with type of scleritis (non-necrotizing and necrotizing), degree of inflammation (0-4+ :≤2+ and >2+), and associated systemic disease.Serum levels of IL-22 were elevated

2016 Acta ophthalmologica

51. Assessment of the Accuracy of Using ICD-9 Codes to Identify Uveitis, Herpes Zoster Ophthalmicus, Scleritis, and Episcleritis. Full Text available with Trip Pro

Assessment of the Accuracy of Using ICD-9 Codes to Identify Uveitis, Herpes Zoster Ophthalmicus, Scleritis, and Episcleritis. With the increased use of data from electronic medical records for research, it is important to validate International Classification of Diseases, Ninth Revision (ICD-9) codes for their respective diagnoses.To assess the accuracy of using ICD-9 codes to identify ocular inflammatory diseases.Retrospective secondary database analysis. The setting was Kaiser Permanente (...) for individual uveitis codes ranged from 0% to 100%, and 11 uveitis codes had a PPV exceeding 80%. Herpes zoster ophthalmicus and scleritis/episcleritis ICD-9 codes had PPVs of 91% (95% CI, 86%-95%) and 60% (95% CI, 54%-66%), respectively.Our results suggest that using ICD-9 codes alone to capture uveitis and scleritis/episcleritis diagnoses is not sufficient in the Kaiser Permanente Hawaii healthcare system, although there were specific uveitis codes with high PPVs. However, the electronic medical record

2016 JAMA ophthalmology

52. Scleritis associated with relapsing polychondritis. (Abstract)

Scleritis associated with relapsing polychondritis. To evaluate ocular disease characteristics and successful therapeutic regimens in patients with scleritis associated with relapsing polychondritis (RP). To compare these features with those seen in patients with scleritis associated with other systemic immune-mediated diseases (SIMD).Electronic health records of 13 scleritis patients associated with RP were analysed and compared with those of 113 scleritis patients associated with other SIMD (...) seen at two tertiary referral centres.Scleritis in patients with RP was often bilateral (92.3%), diffuse (76.9%), recurrent (84.6%), sometimes with decreased vision (46.2%), anterior uveitis (38.5%), peripheral keratitis (15.4%) and ocular hypertension (30.8%). Patients with scleritis associated with RP more often had bilateral scleritis (p=0.001), necrotising scleritis (23.1%; p=0.02), recurrences (p=0.001) and decreased vision (three of the six with legal blindness; p=0.012), as compared

2016 British Journal of Ophthalmology

53. Multifocal Surgically Induced Necrotizing Scleritis Following Strabismus Surgery: A Case Report. (Abstract)

Multifocal Surgically Induced Necrotizing Scleritis Following Strabismus Surgery: A Case Report. To present clinical findings of a 28-year-old woman with multifocal surgically induced necrotizing scleritis following uncomplicated strabismus surgery.A 28-year-old woman underwent uncomplicated strabismus surgery of her right eye for sensory exotropia under general anesthesia (6 mm right medial rectus muscle resection and 8 mm right lateral rectus muscle recession).Retrospective, observational (...) case report and literature review.One month after strabismus surgery, the patient presented with surgically induced necrotizing scleritis in the nasal aspect of sclera. Bacterial culture of the bed of the scleral melt showed no growth and all laboratory evaluation was normal. The scleritis completely resolved after initiation of systemic corticosteroids and oral azathioprine. Three weeks later (after tapering dose of systemic medication), the patient returned with large area of necrotizing

2016 Strabismus

54. Perichondrium Autograft in Refractory Necrotizing Scleritis

Perichondrium Autograft in Refractory Necrotizing Scleritis Perichondrium Autograft in Refractory Necrotizing Scleritis - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Perichondrium Autograft in Refractory (...) Necrotizing Scleritis (PCRNS) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02864823 Recruitment Status : Completed First Posted : August 12, 2016 Last Update Posted : August 12, 2016 Sponsor: Chung-Ang University Hosptial, Chung-Ang University College of Medicine Collaborator: Ministry of Science, ICT

2016 Clinical Trials

55. Surgical treatment of peripheral ulcerative keratitis and necrotizing scleritis in granulomatosis with polyangiitis Full Text available with Trip Pro

Surgical treatment of peripheral ulcerative keratitis and necrotizing scleritis in granulomatosis with polyangiitis The efficacy of surgical management of refractory ophthalmic complications of granulomatosis with polyangiitis (GPA), which is a sight threatening was reported. A 70-year-old man presented with a progressively worsening pain and redness in his right eye during the previous 6 months, and decreasing visual acuity that started one month earlier. He was misdiagnosed and treated (...) as keratitis elsewhere, but the pain has not decreased. The diagnosis of necrotizing scleritis with peripheral ulcerative keratitis (PUK) in GPA was made in our department. Surgery was performed with necrotic tissue removal, combined with cryotherapy and a conjunctival flap covering surgery. The symptom was relieved after surgery, and the patient's ocular condition remained stable thereafter. This case first demonstrates limited ophthalmic GPA (such as, PUK and necrotizing scleritis) that was not sensitive

2016 Saudi medical journal

56. Rheumatoid polyarthritis suspected in an HIV patient with scleritis, peripheral ulcerative keratitis, and anterior uveitis Full Text available with Trip Pro

Rheumatoid polyarthritis suspected in an HIV patient with scleritis, peripheral ulcerative keratitis, and anterior uveitis Scleritis and peripheral ulcerative keratitis are ocular manifestations found in many inflammations and infections. Therefore, their association should prompt a search for inflammatory or infectious causes that may be life-threatening, especially in the context of AIDS due to HIV infection.We report the case of a 37-year-old female, first seen in 2011 with a nodular (...) scleritis in the right eye and a peripheral ulcerative keratitis, a necrotizing scleritis, and a granulomatous anterior uveitis in the left eye, in the context of chronic polyarthropathies that had evolved over 6 months. The patient was diagnosed with AIDS (HIV) in 2008 and was on antiretroviral therapy for the past 2 years. Ophthalmic workup was negative for opportunistic infections and potential causes of scleritis and peripheral ulcerative keratitis, and the patient was unresponsive to topical

2016 International medical case reports journal

57. Nodular scleritis as a presenting feature of Takayasu's arteritis Full Text available with Trip Pro

Nodular scleritis as a presenting feature of Takayasu's arteritis 27221684 2017 08 09 2018 11 13 1998-3689 64 4 2016 Apr Indian journal of ophthalmology Indian J Ophthalmol Nodular scleritis as a presenting feature of Takayasu's arteritis. 312-4 10.4103/0301-4738.182945 Shukla Eesha E B.M.C. Eye Hospital, Mumbai, Maharashtra, India. Desai Akruti A Dr. Agarwal's Eye Hospital, Chennai, Tamilnadu, India. Malkan Nitin N Akshar Eye Clinic, Mumbai, Maharashtra, India. Gokhale Yojana Y Arthritis (...) Centre, Mumbai, Maharashtra, India. eng Case Reports Journal Article India Indian J Ophthalmol 0405376 0301-4738 IM Adult Brachiocephalic Trunk diagnostic imaging Computed Tomography Angiography Female Humans Sclera pathology Scleritis diagnosis etiology Takayasu Arteritis complications diagnosis 2016 5 26 6 0 2016 5 26 6 0 2017 8 10 6 0 ppublish 27221684 IndianJOphthalmol_2016_64_4_312_182945 10.4103/0301-4738.182945 PMC4901850 Br J Ophthalmol. 2000 Jul;84(7):801 11032436 Int J Clin Lab Res. 1999;29

2016 Indian journal of ophthalmology

58. Aspergillus fumigatus Endophthalmitis with Necrotizing Scleritis following Pars Plana Vitrectomy Full Text available with Trip Pro

Aspergillus fumigatus Endophthalmitis with Necrotizing Scleritis following Pars Plana Vitrectomy We present a case of Aspergillus fumigatus endophthalmitis complicated by necrotizing scleritis in a 68-year-old man with diet-controlled diabetes, after retinal detachment repair. He was initially treated with systemic steroids for surgically induced necrotizing scleritis following routine pars plana vitrectomy. An additional diagnosis of endophthalmitis was made when the patient developed (...) a hypopyon. Repeat vitreous culture isolated Aspergillus fumigatus. Symptoms improved following antifungal treatment leaving the patient with scleromalacia and an advanced postoperative cataract. Fungal scleritis and endophthalmitis are rare complications of intraocular surgery with sight-threatening consequences, and, as this case demonstrates, may even occur concomitantly. The overlapping features of both conditions can make differentiating one from the other difficult. A fungal aetiology should

2016 Case reports in ophthalmological medicine

59. Nodular Scleritis Associated with Herpes Zoster Virus: An Infectious and Immune-Mediated Process Full Text available with Trip Pro

Nodular Scleritis Associated with Herpes Zoster Virus: An Infectious and Immune-Mediated Process Purpose. To describe a case of anterior nodular scleritis, preceded by an anterior hypertensive uveitis, which was primarily caused by varicella zoster virus (VZV). Case Report. A 54-year-old woman presented with anterior uveitis of the right eye presumably caused by herpetic viral disease and was successfully treated. Two months later, she developed a nodular scleritis and started oral nonsteroidal (...) anti-inflammatory without effect. A complete laboratory workup revealed positivity for HLA-B27; the infectious workup was negative. Therapy was changed to oral prednisolone and an incomplete improvement occurred. Therefore, a diagnostic anterior paracentesis was performed and the polymerase chain reaction (PCR) analysis revealed VZV. She was treated with valacyclovir and the oral prednisolone began to decrease; however, a marked worsening of the scleritis occurred with the reduction of the daily

2016 Case reports in ophthalmological medicine

60. Second report of a Nocardia beijingensis infection in the United States: nodular scleritis with in vitro imipenem resistance Full Text available with Trip Pro

Second report of a Nocardia beijingensis infection in the United States: nodular scleritis with in vitro imipenem resistance We describe the case of a 52-year-old woman with scleritis caused by an imipenem-resistant strain of Nocardia beijingensis. The patient presented with pain, redness, and nodules on the sclera of 8 weeks' duration. A Gram stain from a nodule on the superonasal aspect of the globe was initially negative. After empiric treatment for an autoimmune etiology, cytopathology (...) confirmed filamentous bacteria. A presumptive diagnosis of Nocardia scleritis was made, and medical management was based on a literature review on treatments for Nocardia infections. Cultures returned confirming Nocardia beijingensis. Antibiotic sensitivity testing confirmed the correct initial management. The patient's scleritis resolved with a good visual outcome.

2016 Digital Journal of Ophthalmology : DJO

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