Epidemiology of episcleritis and scleritis in urban Australia.
epidemiology
incidence
scleritis
Journal
Clinical & experimental ophthalmology
ISSN: 1442-9071
Titre abrégé: Clin Exp Ophthalmol
Pays: Australia
ID NLM: 100896531
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
08
08
2019
revised:
05
03
2020
accepted:
04
04
2020
pubmed:
13
4
2020
medline:
1
9
2021
entrez:
13
4
2020
Statut:
ppublish
Résumé
The epidemiology of episcleritis and scleritis in Australia is largely unknown. To determine the incidence, prevalence and clinical characteristics of episcleritis and scleritis in Melbourne. Retrospective longitudinal study. Patients aged ≥18 years with episcleritis or scleritis seen at the Royal Victorian Eye and Ear Hospital from November 2014 to October 2015. Medical record review confirmed clinical diagnosis and characteristics. Incidence and prevalence were calculated using estimates of the adult population in areas of Melbourne with ≥30 ocular presentations/year to the emergency department. Diagnosis of active episcleritis or scleritis, aetiology, ocular complications and treatments. From a general population of 3 408 068, we confirmed 149 new and 23 pre-existing cases of active episcleritis, and 35 new and 23 pre-existing cases of active scleritis. Incidence per 100 000 person-years was 4.4 (95% confidence interval [CI] 3.7-5.1) for episcleritis and 1.0 (95% CI 0.7-1.4) for scleritis, while 12-month prevalence was 5.1 (95% CI 4.3-5.9) and 1.7 (1.3-2.2) per 100 000 persons, respectively. Systemic disease was associated with 10% of episcleritis compared with 34% of scleritis (P < .001). Ocular complications were seen in 3% (6/184) of episcleritis eyes and 44% (32/72) of scleritis eyes, with the commonest being anterior uveitis (12/72) and ocular hypertension (14/72). At presentation, scleritis patients were commonly treated with oral non-steroidal anti-inflammatory drugs (60%) and prednisolone (19%). By 12 months, 24% of scleritis patients required immunosuppressants. Rates of episcleritis and scleritis in our single-centre Australian study were low. Episcleritis was usually benign, whereas scleritis had increased ocular complications and systemic disease.
Sections du résumé
IMPORTANCE
The epidemiology of episcleritis and scleritis in Australia is largely unknown.
BACKGROUND
To determine the incidence, prevalence and clinical characteristics of episcleritis and scleritis in Melbourne.
DESIGN
Retrospective longitudinal study.
PARTICIPANTS
Patients aged ≥18 years with episcleritis or scleritis seen at the Royal Victorian Eye and Ear Hospital from November 2014 to October 2015.
METHODS
Medical record review confirmed clinical diagnosis and characteristics. Incidence and prevalence were calculated using estimates of the adult population in areas of Melbourne with ≥30 ocular presentations/year to the emergency department.
MAIN OUTCOME MEASURES
Diagnosis of active episcleritis or scleritis, aetiology, ocular complications and treatments.
RESULTS
From a general population of 3 408 068, we confirmed 149 new and 23 pre-existing cases of active episcleritis, and 35 new and 23 pre-existing cases of active scleritis. Incidence per 100 000 person-years was 4.4 (95% confidence interval [CI] 3.7-5.1) for episcleritis and 1.0 (95% CI 0.7-1.4) for scleritis, while 12-month prevalence was 5.1 (95% CI 4.3-5.9) and 1.7 (1.3-2.2) per 100 000 persons, respectively. Systemic disease was associated with 10% of episcleritis compared with 34% of scleritis (P < .001). Ocular complications were seen in 3% (6/184) of episcleritis eyes and 44% (32/72) of scleritis eyes, with the commonest being anterior uveitis (12/72) and ocular hypertension (14/72). At presentation, scleritis patients were commonly treated with oral non-steroidal anti-inflammatory drugs (60%) and prednisolone (19%). By 12 months, 24% of scleritis patients required immunosuppressants.
CONCLUSIONS AND RELEVANCE
Rates of episcleritis and scleritis in our single-centre Australian study were low. Episcleritis was usually benign, whereas scleritis had increased ocular complications and systemic disease.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
757-766Informations de copyright
© 2020 Royal Australian and New Zealand College of Ophthalmologists.
Références
Okhravi N, Odufuwa B, McCluskey P, Lightman S. Scleritis. Surv Ophthalmol. 2005;50(4):351-363.
Homayounfar G, Nardone N, Borkar DS, et al. Incidence of scleritis and episcleritis: results from the Pacific ocular inflammation study. Am J Ophthalmol. 2013;156(4):752-758.
Honik G, Wong IG, Gritz DC. Incidence and prevalence of episcleritis and scleritis in northern California. Cornea. 2013;32(12):1562-1566.
Jabs DA, Mudun A, Dunn JP, Marsh MJ. Episcleritis and scleritis: clinical features and treatment results. Am J Ophthalmol. 2000;130(4):469-476.
Tuft SJ, Watson PG. Progression of scleral disease. Ophthalmology. 1991;98(4):467-471.
Sainz de la Maza M, Molina N, Gonzalez-Gonzalez LA, Doctor PP, Tauber J, Foster CS. Clinical characteristics of a large cohort of patients with scleritis and episcleritis. Ophthalmology. 2012;119(1):43-50.
Hart CT, Zhu EY, Crock C, Rogers SL, Lim LL. Epidemiology of uveitis in urban Australia. Clin Experiment Ophthalmol. 2019;47(6):733-740.
Gritz DC, Wong IG. Incidence and prevalence of uveitis in northern California: the northern California epidemiology of uveitis study. Ophthalmology. 2004;111(3):491-500.
Australian Bureau of Statistics. 2016 Census QuickStats: Greater Melbourne. 2017. http://www.censusdata.abs.gov.au/census_services/getproduct/census/2016/quickstat/2GMEL. Accessed September 20, 2017.
Akpek EK, Thorne JE, Qazi FA, Do DV, Jabs DA. Evaluation of patients with scleritis for systemic disease. Ophthalmology. 2004;111(3):501-506.
Homayounfar G, Borkar DS, Tham VM, Nardone N, Acharya NR. Clinical characteristics of scleritis and episcleritis: results from the pacific ocular inflammation study. Ocul Immunol Inflamm. 2014;22(5):403-404.
Fujimoto S, Watts RA, Kobayashi S, et al. Comparison of the epidemiology of anti-neutrophil cytoplasmic antibody-associated vasculitis between Japan and the U.K. Rheumatology. 2011;50(10):1916-1920.
Sainz de la Maza M, Molina N, Gonzalez-Gonzalez LA, Doctor PP, Tauber J, Foster CS. Scleritis therapy. Ophthalmology. 2012;119(1):51-58.
Sohn EH, Wang R, Read R, et al. Long-term, multicenter evaluation of subconjunctival injection of triamcinolone for non-necrotizing, noninfectious anterior scleritis. Ophthalmology. 2011;118(10):1932-1937.