SCLERITIS ASSOCIATED WITH SYSTEMIC VASCULITIC DISEASES

Purpose: Scleritis may occur associated with systemic vasculitic disea ses. The detection of systemic vasculitic diseases in patients with sc leritis is a sign of poor general prognosis because it indicates poten tially lethal systemic complications. This study was undertaken to ana lyze the ocular prognosis of patients with scleritis and the different systemic vasculitic diseases. Methods: Patient characteristics, scler itis type, and ocular complications were evaluated in 82 patients with scleritis with systemic vasculitic diseases; comparisons were made be tween patients with scleritis with a specific systemic vasculitic dise ases and patients with scleritis with the other systemic vasculitic di seases. Results: Patients with scleritis with Wegener granulomatosis h ad more necrotizing scleritis (79%, P = 0.0001), decrease in vision (7 9%, P = 0.014), and peripheral ulcerative keratitis (50%, P = 0.0139) than patients with scleritis with the other systemic vasculitic diseas es. Patients with scleritis with spondyloarthropathies had less decrea se in vision (8%, P = 0.001) and peripheral ulcerative keratitis (0%, P = 0.0256) than patients with scleritis with the other systemic vascu litic diseases. Patients with scleritis and systemic lupus erythematos us had less necrotizing scleritis (0%, P = 0.0412) than patients with scleritis with the other systemic vasculitic diseases. Conclusions: Oc ular prognosis of scleritis with systemic vasculitic diseases varies d epending on the specific systemic vasculitic diseases: scleritis in sp ondyloarthropathies or in systemic lupus erythematosus is usually a be nign and self-limiting condition, whereas scleritis in Wegener granulo matosis is a severe disease that can lead to permanent blindness; scle ritis in rheumatoid arthritis or relapsing polychondritis is a disease of intermediate severity, which should be monitored closely for the d evelopment of ocular complications.