Scleritis

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In ophthalmology, Scleritis is "refers to any inflammation of the sclera including episcleritis, a benign condition affecting only the episclera, which is generally short-lived and easily treated. Classic scleritis, on the other hand, affects deeper tissue and is characterized by higher rates of visual acuity loss and even mortality, particularly in necrotizing form. Its characteristic symptom is severe and general head pain. Scleritis has also been associated with systemic collagen disease. Etiology is unknown but is thought to involve a local immune response. Treatment is difficult and includes administration of anti-inflammatory and immunosuppressive agents such as corticosteroids. Inflammation of the sclera may also be secondary to inflammation of adjacent tissues, such as the conjunctiva"[1]

Treatment

Tumor necrosis factor (TNF) inhibitors

The role TNF inhibitors of has been addressed by clinical practice guidelines which state:[2]

  • "Infliximab and adalimumab can be considered as potential second-line immunomodulatory agents for the treatment of severe ocular inflammatory conditions including posterior uveitis, panuveitis, severe uveitis associated with seronegative spondyloarthropathy, and scleritis in patients requiring immunomodulation in patients who have failed or who are not candidates for antimetabolite or calcineurin inhibitor immunomodulation. Infliximab and adalimumab can be considered in these patients in preference to etanercept, which seems to be associated with lower rates of treatment success."

Antimetabolites

Calcineurin inhibitors

External links

The most up-to-date information about Scleritis and other drugs can be found at the following sites.


References

  1. Anonymous (2015), Scleritis (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. Levy-Clarke G, Jabs DA, Read RW, Rosenbaum JT, Vitale A, Van Gelder RN (2014). "Expert panel recommendations for the use of anti-tumor necrosis factor biologic agents in patients with ocular inflammatory disorders.". Ophthalmology 121 (3): 785-96.e3. DOI:10.1016/j.ophtha.2013.09.048. PMID 24359625. Research Blogging.