Scleritis: A clinicopathologic study of 55 cases
Section snippets
Materials and methods
A total of 55 cases of scleritis were included in this study (Table 1). Thirty-eight cases were obtained from the files of the A. Ray Irvine Ocular Pathology Laboratory of the Doheny Eye Institute; 3 of these had been brought back from the Verhoeff Society Meeting (1 case was presented by Peter R. Egbert, MD, 1 by Robert A. Levine, MD, and 1 by Alan M. Roth, MD). The remaining 17 cases were obtained from the Armed Forces Institute of Pathology (AFIP). Eleven of the Doheny Eye Institute cases
Results
The results are summarized in Table 1. The specimens submitted for histopathologic examination consisted of 46 enucleated eyes and 9 scleral biopsy specimens. All nine biopsy specimens were obtained from the anterior sclera of patients with a clinical diagnosis of anterior scleritis; five of these patients belonged to group 2 and four to group 3. The patients ranged in age from 22 to 95 years (mean = 61.6 ± 19.7 years, median = 68 years). Twenty-eight patients were women; 25 were men. In two
Discussion
The systemic immune-mediated disease most frequently associated with scleritis is rheumatoid arthritis.1, 5 In the previous clinicopathologic study of necrotizing scleritis,6 rheumatoid scleritis could be differentiated histologically from idiopathic scleritis. On the basis of such histologic criteria, 14 (25.4%) of the 55 cases in the present study showed histologic features of zonal necrotizing granulomatous inflammation (Fig 1). Twelve of these 14 cases showed clinical evidence of systemic
Acknowledgements
The authors thank John A. Irvine, MD, for providing the clinical photograph of culture-proven Pseudomonas scleritis.
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The authors have no proprietary interest in any of the materials used in this study.