SCLERITIS ASSOCIATED WITH RHEUMATOID-ARTHRITIS AND WITH OTHER SYSTEMIC IMMUNE-MEDIATED DISEASES

Purpose: Rheumatoid arthritis is the most common systemic immune-media ted condition associated with scleritis. The purpose of this study is to determine whether or not scleritis is more severe in patients with rheumatoid arthritis than in those without associated disease (''idiop athic scleritis''), or than in patients with other systemic immune-med iated diseases. Methods: Patient characteristics, type of scleritis, a nd ocular complications of 32 patients with scleritis associated with rheumatoid arthritis were compared with those of 74 patients with idio pathic scleritis and with those of 50 patients with scleritis associat ed with other systemic immune-mediated diseases.Results: Patients with scleritis associated with rheumatoid arthritis were older (mean age, 60.78; P = 0.0011) and more often had necrotizing scleritis (34%; P = 0.0001), decrease in vision (59%; P = 0.0001), and peripheral ulcerati ve keratitis (31%; P = 0.0001) than patients with idiopathic scleritis ; by contrast, there was no statistical association with sex, bilatera lity, anterior uveitis, glaucoma, or cataract. Patients with scleritis associated with rheumatoid arthritis were older (P = 0.0261) and more often had bilateral scleritis (53%; P = 0.0221) than patients with sc leritis associated with other systemic immune-mediated diseases; howev er, there was no statistical association with type of scleritis, sex, decrease in vision, anterior uveitis, peripheral ulcerative keratitis, glaucoma, or cataract. Conclusions: Scleritis associated with rheumat oid arthritis is more severe than idiopathic scleritis but is as sever e as scleritis associated with other immune-mediated diseases.