The following is a summary of “Scleritis and development of immune-mediated disease: A retrospective chart review,” published in the August 2024 issue of Rheumatology by Morrison et al.

Scleritis can be idiopathic or be triggered by trauma, infections, or immune-mediated diseases (IMD).

Researchers conducted a retrospective study exploring the correlation between scleritis and IMD, focusing on symptoms, blood tests, and treatment outcomes, potentially aiding in risk stratification and prediction of clinical outcomes.

They reviewed a chart of 341 patients with scleritis treated at a tertiary care center (January 1, 2005, to December 31, 2020), comparing demographics, scleritis features, treatment response, recurrence, and serologic data between idiopathic and IMD-associated cases.

The result showed that of the reviewed patients with scleritis, 145 (43%) had an associated IMD, mostly with rheumatoid arthritis (RA [39%]), vasculitis (21%), and inflammatory bowel disease (14%). In most cases, the IMD diagnosis preceded the onset of scleritis (63%), and vasculitis was more likely to occur concurrently with or following scleritis episodes. No significant differences were observed in demographics or treatment failures between patients with and without associated IMDs. However, patients with IMDs had a higher probability of scleritis recurrence (62% vs 49%, P=0.02).

Investigators concluded that 43% of scleritis patients had an IMD, usually appearing before scleritis. RA was the most common, typically pre-dating scleritis, while vasculitis often appeared later. IMD-related scleritis was more likely to recur than idiopathic cases.

Source: jrheum.org/content/51/8/825