The following is a summary of “Effectiveness of difluprednate in addition to systemic therapy for the treatment of anterior scleritis,” published in the September 2023 issue of Ophthalmology by Liberman et al.

Researchers conducted a retrospective study to investigate the efficacy and safety of difluprednate therapy as an adjunct to systemic therapy for anterior scleritis.

They reviewed charts from all patients with anterior scleritis treated with topical difluprednate in addition to systemic therapy (January 1, 2018, and January 1, 2020). The collected data encompassed demographics, scleritis type, systemic diagnosis, presence of nodules or necrosis, changes in scleritis activity, intraocular pressure (IOP), amount of difluprednate drops utilized, type of systemic treatment, best-corrected visual acuity (BCVA), and lens status. The primary outcome was the clinical resolution of scleritis. Secondary outcomes are BCVA loss ≥2 lines, lens status/cataract surgery, and IOP ≥24 mm Hg.

The results showed 32 patients (44 eyes). The median age was 57 years (IQR 52, 72), with 59% female and 72% caucasian ethnicity. An associated systemic disease was present in 59% of cases. When difluprednate was added, systemic therapies included 65% immunosuppressive agents, 43% prednisone, and 25% non-steroidal anti-inflammatory drugs. Adding difluprednate achieved clinical resolution in 79.6% of treated eyes, with a median time to inactivity of 9 weeks (IQR 5, 20). Eyes initially using 2–4 drops daily exhibited a higher response rate (89%, P=0.005). Over a median follow-up of 34 weeks (IQR 21, 74), 11 eyes experienced elevated IOP, 6 eyes lost ≥2 lines of BCVA, and 5 eyes had cataract progression.

They concluded difluprednate therapy can achieve inactivity in most eyes with anterior scleritis when added to systemic therapies.

Source: bjo.bmj.com/content/early/2023/09/03/bjo-2022-322841