SCLERITIS-ASSOCIATED UVEITIS

Purpose: Anterior uveitis may accompany scleritis. This study was unde rtaken to analyze the incidence, characteristics, and meaning of uveit is in the course of scleritis. Methods: Patient characteristics, scler itis type, ocular complications, and specific systemic diseases were e valuated in patients with scleritis-associated uveitis; comparisons we re made between patients with scleritis-associated uveitis and patient s with scleritis without uveitis. Results: Seventy three (42%) of 172 patients with scleritis had anterior uveitis. Scleritis-associated uve itis ranged from mild to moderate intensity and always was related to the presence of active scleritis. Patients with scleritis-associated u veitis had more necrotizing scleritis (37%, P = 0.0001), decrease in v ision (49%, P = 0.0046), peripheral ulcerative keratitis (22%, P = 0.0 095), and glaucoma (19%, P = 0.0313) than did patients with scleritis without uveitis. Patients with scleritis-associated uveitis did not ha ve any specific associated systemic disease more often than did patien ts with scleritis without uveitis. Conclusion: Extension of scleral in flammation to the anterior uveal tract is a consequence of a more seve re disease with possible ocular complications that may cause progressi ve visual loss. The occurrence of anterior uveitis in the course of sc leritis entails a poor ocular prognosis. The authors believe, therefor e, that the anterior uveal tract should be evaluated at every follow-u p visit of a patient with scleritis, so that emergence of this importa nt prognostic condition (anterior uveitis) may be detected promptly an d systemic therapy instituted appropriately.