To describe clinical characteristics of patients with combined anterior and posterior scleritis at a tertiary eye center.
Retrospective analysis of clinical records of patients presenting with combined scleritis to a tertiary eye care institute between 2015 and 2020
The study included 14 eyes of 12 patients with combined scleritis with a mean age of 42 ± 19 years (range: 12–73 years). With no gender preponderance (50%), the majority of the combined scleritis cases were unilateral (n=10, 83%). Concurrent anterior scleritis in the form of diffuse scleritis was found in eleven (79%) eyes and necrotizing scleritis in 3 (21%) eyes with posterior scleritis. Choroidal folds at the posterior pole were the most common fundus findings in eleven (79%) eyes. A systemic association could be detected in 34% of patients after extensive laboratory workup and multidisciplinary consultation. Oral corticosteroid was the mainstay of management, and 14% of them required pulse corticosteroid therapy. Half of the patients required immunosuppressives, and methotrexate (50%) was the most common immunosuppressive. Recurrence was noted in six (43%) eyes. The mean best-corrected visual acuity improved to logarithm of the minimal angle of resolution (logMAR) 0.87 ± 1.33 at the final follow-up from 0.47 ± 1.10 logMAR at presentation (P = 0.006).
Combined scleritis is a relatively rare but important cause of scleritis that needs aggressive management.