Clinical patterns and risk factors in scleritis: a multicentric study in Colombia

Alejandra de-la-Torre; Mariana Cabrera-Pérez; Claudia Durán; Sandra García; Miguel Cuevas; Néstor Carreño; Carlos M. Rangel; Diana Isabel Pachón-Suárez; María Alejandra Martínez-Ceballos; María Elisa Mejía; Alejandra Gómez-Rocha; Camilo Andrés Gómez-Durán; Yanny Pérez; Juliana Reyes-Guanes; Carlos Cifuentes-González; William Rojas-Carabali

doi:10.1007/s00417-022-05754-y

Clinical patterns and risk factors in scleritis: a multicentric study in Colombia

Título traducido de la contribución: Patrones clínicos y factores de riesgo en escleritis: un estudio multicéntrico en Colombia

Alejandra de-la-Torre, Mariana Cabrera-Pérez, Claudia Durán, Sandra García, Miguel Cuevas, Néstor Carreño, Carlos M. Rangel, Diana Isabel Pachón-Suárez, María Alejandra Martínez-Ceballos, María Elisa Mejía, Alejandra Gómez-Rocha, Camilo Andrés Gómez-Durán, Yanny Pérez, Juliana Reyes-Guanes, Carlos Cifuentes-González, William Rojas-Carabali

Producción científica: Contribución a una revista › Artículo › revisión exhaustiva

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Resumen

Propósito: Este estudio tiene como objetivo describir las características clínicas de la escleritis en una amplia cohorte de pacientes colombianos e identificar los factores asociados con la presentación clínica. Métodos: Serie de casos retrospectiva de pacientes con escleritis entre 2015 y 2020. Se obtuvieron historias clínicas de siete centros de referencia de uveítis en Colombia. Se excluyeron pacientes con diagnóstico de epiescleritis. Resultados: Se evaluaron 389 pacientes con escleritis (509 ojos). Hubo un predominio del sexo femenino (75,6%) con una edad media de 51 ± 15 años. La mayoría de los casos fueron no infecciosos (94,8%) y unilaterales (69,2%). El tipo de inflamación más frecuente fue la escleritis anterior difusa (41,7%), seguida de la escleritis nodular (31,9%) y la escleritis necrotizante (12,3%). Se detectaron enfermedades autoinmunes sistémicas en el 41,3% de los pacientes, siendo las más frecuentes la artritis reumatoide (18,5%) y la granulomatosis con poliangeítis (5,9%). El 10,4% de los pacientes con una enfermedad autoinmune sistémica presentaban poliautoinmunidad. El tratamiento más frecuente fueron los corticoides sistémicos (50,9%), seguidos de los AINE sistémicos (32,4%). El 49,1% de los pacientes precisaron inmunosupresión con esteroides. Las enfermedades autoinmunes sistémicas fueron más frecuentes en los pacientes con escleritis necrotizante y en los mayores de 40 años. La agudeza visual mejor corregida de 20/80 o peor en el momento de la presentación fue más frecuente en la escleritis necrotizante y en los sujetos con uveítis asociada, hipertensión ocular o mayores de 40 años. Conclusiones: Este es el primer estudio en Colombia y el más grande en Latinoamérica que describe las características clínicas y los patrones de presentación de la escleritis. La presentación más común fue en mujeres, con escleritis difusa anterior unilateral no infecciosa. Las enfermedades autoinmunes sistémicas y la poliautoinmunidad fueron frecuentes, así como la necesidad de inmunosupresión con ahorro de esteroides. La edad superior a 40 años y la escleritis necrotizante se asociaron con mayores probabilidades de padecer una enfermedad autoinmune sistémica y peor agudeza visual en el momento de la presentación.

Título traducido de la contribución	Patrones clínicos y factores de riesgo en escleritis: un estudio multicéntrico en Colombia
Idioma original	Inglés estadounidense
Páginas (desde-hasta)	3957–3967
Número de páginas	11
Publicación	Graefe's Archive for Clinical and Experimental Ophthalmology
Volumen	260
DOI	https://doi.org/10.1007/s00417-022-05754-y
Estado	Publicada - jul. 7 2022

Áreas temáticas de ASJC Scopus

Oftalmología
Sistema sensorial
Neurociencia celular y molecular

ODS de las Naciones Unidas

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de-la-Torre, A., Cabrera-Pérez, M., Durán, C., García, S., Cuevas, M., Carreño, N., Rangel, C. M., Pachón-Suárez, D. I., Martínez-Ceballos, M. A., Mejía, M. E., Gómez-Rocha, A., Gómez-Durán, C. A., Pérez, Y., Reyes-Guanes, J., Cifuentes-González, C., & Rojas-Carabali, W. (2022). Clinical patterns and risk factors in scleritis: a multicentric study in Colombia. Graefe's Archive for Clinical and Experimental Ophthalmology, 260, 3957–3967. https://doi.org/10.1007/s00417-022-05754-y

@article{af1ad3634c2a47a087f52700b98f609d,

title = "Clinical patterns and risk factors in scleritis: a multicentric study in Colombia",

abstract = "Purpose: This study aims to describe the clinical characteristics of scleritis in a large cohort of Colombian patients and identify factors associated with the clinical presentation. Methods: Retrospective case series of patients with scleritis from 2015 to 2020. Clinical records were obtained from seven uveitis referral centers in Colombia. Patients with a diagnosis of episcleritis were excluded. Results: We evaluated 389 patients with scleritis (509 eyes). There was a female predominance (75.6%) with a mean age of 51 ± 15 years. Most cases were noninfectious (94.8%) and unilateral (69.2%). The most frequent type of inflammation was diffuse anterior scleritis (41.7%), followed by nodular scleritis (31.9%) and necrotizing scleritis (12.3%). Systemic autoimmune diseases were found in 41.3% of patients, the most common being rheumatoid arthritis (18.5%) and granulomatosis with polyangiitis (5.9%). Polyautoimmunity was found in 10.4% of those with a systemic autoimmune disease. The most frequent treatment was systemic steroids (50.9%), followed by systemic NSAIDs (32.4%). Steroid-sparing immunosuppression was required in 49.1% of patients. Systemic autoimmune diseases were more common in patients with necrotizing scleritis and those older than 40 years of age. Best-corrected visual acuity of 20/80 or worse at presentation was more common in necrotizing scleritis and subjects with associated uveitis, ocular hypertension, or who were over 40 years of age. Conclusions: This is the first study in Colombia and the largest in Latin America describing the clinical characteristics and presentation patterns of scleritis. The most common presentation was in females, with unilateral, anterior diffuse noninfectious scleritis. Systemic autoimmune diseases and polyautoimmunity were frequent, as was the need for steroid-sparing immunosuppression. Age over 40 and necrotizing scleritis were associated with higher odds of having a systemic autoimmune disease and worse visual acuity at presentation.",

author = "Alejandra de-la-Torre and Mariana Cabrera-P{\'e}rez and Claudia Dur{\'a}n and Sandra Garc{\'i}a and Miguel Cuevas and N{\'e}stor Carre{\~n}o and Rangel, {Carlos M.} and Pach{\'o}n-Su{\'a}rez, {Diana Isabel} and Mart{\'i}nez-Ceballos, {Mar{\'i}a Alejandra} and Mej{\'i}a, {Mar{\'i}a Elisa} and Alejandra G{\'o}mez-Rocha and G{\'o}mez-Dur{\'a}n, {Camilo Andr{\'e}s} and Yanny P{\'e}rez and Juliana Reyes-Guanes and Carlos Cifuentes-Gonz{\'a}lez and William Rojas-Carabali",

note = "Publisher Copyright: {\textcopyright} 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.",

year = "2022",

month = jul,

day = "7",

doi = "10.1007/s00417-022-05754-y",

language = "English (US)",

volume = "260",

pages = "3957–3967",

journal = "Graefe's Archive for Clinical and Experimental Ophthalmology",

issn = "0721-832X",

publisher = "Springer",

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de-la-Torre, A, Cabrera-Pérez, M, Durán, C, García, S, Cuevas, M, Carreño, N, Rangel, CM, Pachón-Suárez, DI, Martínez-Ceballos, MA, Mejía, ME, Gómez-Rocha, A, Gómez-Durán, CA, Pérez, Y, Reyes-Guanes, J, Cifuentes-González, C & Rojas-Carabali, W 2022, 'Clinical patterns and risk factors in scleritis: a multicentric study in Colombia', Graefe's Archive for Clinical and Experimental Ophthalmology, vol. 260, pp. 3957–3967. https://doi.org/10.1007/s00417-022-05754-y

TY - JOUR

T1 - Clinical patterns and risk factors in scleritis: a multicentric study in Colombia

AU - de-la-Torre, Alejandra

AU - Cabrera-Pérez, Mariana

AU - Durán, Claudia

AU - García, Sandra

AU - Cuevas, Miguel

AU - Carreño, Néstor

AU - Rangel, Carlos M.

AU - Pachón-Suárez, Diana Isabel

AU - Martínez-Ceballos, María Alejandra

AU - Mejía, María Elisa

AU - Gómez-Rocha, Alejandra

AU - Gómez-Durán, Camilo Andrés

AU - Pérez, Yanny

AU - Reyes-Guanes, Juliana

AU - Cifuentes-González, Carlos

AU - Rojas-Carabali, William

PY - 2022/7/7

Y1 - 2022/7/7

N2 - Purpose: This study aims to describe the clinical characteristics of scleritis in a large cohort of Colombian patients and identify factors associated with the clinical presentation. Methods: Retrospective case series of patients with scleritis from 2015 to 2020. Clinical records were obtained from seven uveitis referral centers in Colombia. Patients with a diagnosis of episcleritis were excluded. Results: We evaluated 389 patients with scleritis (509 eyes). There was a female predominance (75.6%) with a mean age of 51 ± 15 years. Most cases were noninfectious (94.8%) and unilateral (69.2%). The most frequent type of inflammation was diffuse anterior scleritis (41.7%), followed by nodular scleritis (31.9%) and necrotizing scleritis (12.3%). Systemic autoimmune diseases were found in 41.3% of patients, the most common being rheumatoid arthritis (18.5%) and granulomatosis with polyangiitis (5.9%). Polyautoimmunity was found in 10.4% of those with a systemic autoimmune disease. The most frequent treatment was systemic steroids (50.9%), followed by systemic NSAIDs (32.4%). Steroid-sparing immunosuppression was required in 49.1% of patients. Systemic autoimmune diseases were more common in patients with necrotizing scleritis and those older than 40 years of age. Best-corrected visual acuity of 20/80 or worse at presentation was more common in necrotizing scleritis and subjects with associated uveitis, ocular hypertension, or who were over 40 years of age. Conclusions: This is the first study in Colombia and the largest in Latin America describing the clinical characteristics and presentation patterns of scleritis. The most common presentation was in females, with unilateral, anterior diffuse noninfectious scleritis. Systemic autoimmune diseases and polyautoimmunity were frequent, as was the need for steroid-sparing immunosuppression. Age over 40 and necrotizing scleritis were associated with higher odds of having a systemic autoimmune disease and worse visual acuity at presentation.

AB - Purpose: This study aims to describe the clinical characteristics of scleritis in a large cohort of Colombian patients and identify factors associated with the clinical presentation. Methods: Retrospective case series of patients with scleritis from 2015 to 2020. Clinical records were obtained from seven uveitis referral centers in Colombia. Patients with a diagnosis of episcleritis were excluded. Results: We evaluated 389 patients with scleritis (509 eyes). There was a female predominance (75.6%) with a mean age of 51 ± 15 years. Most cases were noninfectious (94.8%) and unilateral (69.2%). The most frequent type of inflammation was diffuse anterior scleritis (41.7%), followed by nodular scleritis (31.9%) and necrotizing scleritis (12.3%). Systemic autoimmune diseases were found in 41.3% of patients, the most common being rheumatoid arthritis (18.5%) and granulomatosis with polyangiitis (5.9%). Polyautoimmunity was found in 10.4% of those with a systemic autoimmune disease. The most frequent treatment was systemic steroids (50.9%), followed by systemic NSAIDs (32.4%). Steroid-sparing immunosuppression was required in 49.1% of patients. Systemic autoimmune diseases were more common in patients with necrotizing scleritis and those older than 40 years of age. Best-corrected visual acuity of 20/80 or worse at presentation was more common in necrotizing scleritis and subjects with associated uveitis, ocular hypertension, or who were over 40 years of age. Conclusions: This is the first study in Colombia and the largest in Latin America describing the clinical characteristics and presentation patterns of scleritis. The most common presentation was in females, with unilateral, anterior diffuse noninfectious scleritis. Systemic autoimmune diseases and polyautoimmunity were frequent, as was the need for steroid-sparing immunosuppression. Age over 40 and necrotizing scleritis were associated with higher odds of having a systemic autoimmune disease and worse visual acuity at presentation.

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JO - Graefe's Archive for Clinical and Experimental Ophthalmology

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Clinical patterns and risk factors in scleritis: a multicentric study in Colombia

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