EP195 - Patterns of sclero-uveitis in a referral center in Tunisia, North Africa

DOUKH Meryem

JALLOULI Aida

BEN AMOR Hager

KHOCHTALI Sana

KSIAA Imen

KHAIRALLAH Moncef

Purpose

To describe the demographics and clinical characteristics of anterior scleritis associated with uveitis in a referral center in Tunisia

Methods

The charts of twenty patients diagnosed with sclero-uveitis at Fattouma Bourguiba University Hospital, Monastir, Tunisia, presented between January 2015 and April 2022, were retrospectively reviewed.Detailed ophthalmic examination and fundus photography were performed in all patients. Mean follow-up period was 28.4 months. Patients with keratitis or posterior scleritis were excluded.

Results

There were 8 women and 12 males patients with a mean age of 34.8 years. All patients presented with ocular pain. Mean initial best-corrected visual acuity (BCVA) was 20/80 (range, 20/2000-20/25).There was an associated anterior uveitis in 80% of cases and panuveitis in 20%. Clinical findings at presentation included nodular scleritis in 5 eyes (25%) and scleromalacia perforans in 4 eyes (20%). Idiopathic sclero-uveitis accounted for almost 55%. Identified causes of sclerouveitis included rheumatoid arthritis in 4 eyes (20%), tuberculosis in 3 eyes (15%), granulomatosis with polyangiitis in 2 eyes (10%), sarcoidosis in one eye (5%) and then one case after mRNA 1273 vaccine (5%). Ocular complications included pupillary seclusion in 25% of cases and vision loss in 10% of patients. Mean final BCVA was 20/100 (range, 20/4000- 20/32). Treatment modalities of non-infectious scleritis included indomethacine in 14 patients (82,3%), systemic corticosteroid in 7 patients (41,1%) and immunosuppressant or biological agent in 5 patients (29,4%).

Conclusions

Our results provide useful information about the patterns and etiologies of sclerouveitis. The leading causes of sclerouveitis include mainly rheumatoid arthritis and tuberculosis. An infectious cause should be always ruled out.




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