ULTRASOUND BIOMICROSCOPY IN SCLERITIS

Objective: This study aimed to investigate the usefulness of ultrasoun d biomicroscopy (UBM) for detecting and following up scleritis and epi scleritis. Design: The study design was a case series. Participants: P atients with scleral inflammatory diseases (n = 16) were examined. Int ervention: Patient-reported problems and slit-lamp and UBM (50-MHz tra nsducer) findings were compared retrospectively for signs of scleral i nflammation. Main Outcome Measures: Thickness, reflectivity, and homog eneity of the sclera and episclera were the criteria for discriminatin g between the different types of scleritis with the UBM technique, Res ults: Scleral disease was associated with Wegener disease (n = 3), Cog an disease (n = 1), Hashimoto thyroiditis (n = 1), myositis (n = 1), o r panuveitis (n = 1). Initial slit-lamp evaluation showed episcleritis (n = 3), diffuse scleritis (n = 9), nodular scleritis (n = 3), or nec rotizing scleritis (n = 1). By means of UBM analysis, the diagnosis of episcleritis or scleritis was in agreement with the slit-lamp finding s in 2 of 3 and 6 of 13 cases, respectively. In contrast to the slit-l amp diagnosis, UBM studies excluded scleritis in one patient, disclose d necrosis in four patients with scleritis, and detected nodular scler itis patterns in two further patients with diffuse scleritis. The dete rmination of complete remission, improvement, or progression of diseas e by slit-lamp and UBM evaluation was in agreement in 11 of the 14 pat ients examined, However, UBM was superior to slit-lamp examination wit h respect to detecting scleral necrosis, scleral thinning, or the nodu lar type of scleritis. Conclusions: The findings indicate that UBM is helpful in rapidly differentiating scleritis from severe episcleritis, detecting the diverse scleritis types with high accuracy, disclosing minimal disease progression, and judging treatment efficacy.