Determinants of Non-infectious Scleritis Complications and Their Impact on Visual Outcome: Results from the International AIDA Network Scleritis Registry

INTRODUCTION: Scleritis is a rare and severe ocular inflammatory disease that is often associated with potentially sight-threatening ocular complications. The aim of the present study was to characterize ocular complications in non-infectious scleritis and identify predictive variables for their development. METHODS: Data for this registry-based study were extracted from the AutoInflammatory Disease Alliance Network for Scleritis Registry. Univariate analysis was performed to examine potential associations of demographic and clinical variables with the development of ocular complications. Uveitis and peripheral ulcerative keratitis were considered to be extensions of the inflammatory process and not to be true structural complications. Predictive factors of ocular complications were assessed using regression analysis. The impact of ocular complications on visual acuity-measured by best-corrected visual acuity (BCVA)-was also analyzed. RESULTS: A total of 154 patients (218 eyes) with non-infectious scleritis were enrolled. In 58 of these patients (87 eyes), 102 ocular complications were recorded, with cataract, scleral and corneal thinning, and glaucoma and/or increased ocular pressure being the most frequently recorded complications. Ocular complications were found to be significantly more frequent among patients affected by granulomatosis with polyangiitis (GPA) (p < 0.0001) and concomitant uveitis (p = 0.023). The mean severity score was significantly higher among eyes experiencing ocular complications (p < 0.0001). Regression analysis identified three variables capable of predicting the development of ocular complications: a diagnosis of GPA [odds ratio (OR) 7.747, p < 0.0001]; the presence of concomitant uveitis (OR 3.648, p = 0.019); and a high severity score (OR 1.138, p = 0.044). Mean (± standard deviation) BCVA converted to logMAR was found to be significantly higher among eyes without ocular complications (0.12 ± 0.24 vs 0.27 ± 0.49; p = 0.005). CONCLUSION: Scleritis was accompanied by irreversible ocular complications in a considerable proportion of the patients enrolled in this study. Patients with a diagnosis of GPA, concomitant uveitis, and a higher severity score are more likely to develop ocular complications, and thus warrant a tighter follow-up schedule and early treatment in order to minimize the risk of poor visual prognosis.

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Journal
Ophthalmology and Therapy
Published
2026-05-09
DOI
https://doi.org/10.1007/s40123-026-01390-5
Primary Topic
Ocular Diseases and Behçet’s Syndrome
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article
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article

Determinants of Non-infectious Scleritis Complications and Their Impact on Visual Outcome: Results from the International AIDA Network Scleritis Registry

Guillermo Ruiz‐Irastorza, Marco Capodiferro, M. Thabet, Maria Pia Paroli et al.
Ophthalmology and Therapy
Ocular Diseases and Behçet’s Syndrome
article

Determinants of Non-infectious Scleritis Complications and Their Impact on Visual Outcome: Results from the International AIDA Network Scleritis Registry

Guillermo Ruiz‐Irastorza, Marco Capodiferro, M. Thabet, Maria Pia Paroli, Andrea Hinojosa‐Azaola, Benedetta Monosi, Henrique Ayres Mayrink Giardini, G. H. Ragab, Maria Sole Chimenti, Valeria Caggiano, Paola Parronchi, Samar Tharwat, Alberto Balistreri, Silvana Guerriero, Alex Fonollosa, Perla Ayumi Kawakami‐Campos, Serena Bugatti, Mohamed Tharwat Hegazy, Carla Gaggiano, Ezgi Deniz Batu, Jessica Sbalchiero, Juan José García-Madero, Rafael Tierradentro-Alape, Maite Sainz-de-la-Maza, Antonio Vitale, Eduardo Martín-Nares, Giacomo Emmi, Claudia Fabiani, Marco Cattalini, Alejandra de-la-Torre, José Hernández-Rodríguez, Bruno Frediani, Alma Nunzia Olivieri, Pravin Hissaria, Study Group of Systemic Autoinflammatory Disease of SIR (Italian Society of Rheumatology), Marc Beecher, Luciana Breda, Rosanna Dammacco, Kerolos Afifi, Seza Ozen, Guillermo Arturo Guaracha-Basañez, Piero Ruscitti, Giuseppe Lopalco, Vishali Gupta, Luca Cantarini, Jurgen Sota
article en

Abstract

INTRODUCTION: Scleritis is a rare and severe ocular inflammatory disease that is often associated with potentially sight-threatening ocular complications. The aim of the present study was to characterize ocular complications in non-infectious scleritis and identify predictive variables for their development. METHODS: Data for this registry-based study were extracted from the AutoInflammatory Disease Alliance Network for Scleritis Registry. Univariate analysis was performed to examine potential associations of demographic and clinical variables with the development of ocular complications. Uveitis and peripheral ulcerative keratitis were considered to be extensions of the inflammatory process and not to be true structural complications. Predictive factors of ocular complications were assessed using regression analysis. The impact of ocular complications on visual acuity-measured by best-corrected visual acuity (BCVA)-was also analyzed. RESULTS: A total of 154 patients (218 eyes) with non-infectious scleritis were enrolled. In 58 of these patients (87 eyes), 102 ocular complications were recorded, with cataract, scleral and corneal thinning, and glaucoma and/or increased ocular pressure being the most frequently recorded complications. Ocular complications were found to be significantly more frequent among patients affected by granulomatosis with polyangiitis (GPA) (p < 0.0001) and concomitant uveitis (p = 0.023). The mean severity score was significantly higher among eyes experiencing ocular complications (p < 0.0001). Regression analysis identified three variables capable of predicting the development of ocular complications: a diagnosis of GPA [odds ratio (OR) 7.747, p < 0.0001]; the presence of concomitant uveitis (OR 3.648, p = 0.019); and a high severity score (OR 1.138, p = 0.044). Mean (± standard deviation) BCVA converted to logMAR was found to be significantly higher among eyes without ocular complications (0.12 ± 0.24 vs 0.27 ± 0.49; p = 0.005). CONCLUSION: Scleritis was accompanied by irreversible ocular complications in a considerable proportion of the patients enrolled in this study. Patients with a diagnosis of GPA, concomitant uveitis, and a higher severity score are more likely to develop ocular complications, and thus warrant a tighter follow-up schedule and early treatment in order to minimize the risk of poor visual prognosis.

Ophthalmology and Therapy
South Australia Pathology (AU), University of Rome Tor Vergata (IT), Damietta University (EG), Royal Adelaide Hospital (AU), Cairo University (EG), Mansoura University (EG), University of the Basque Country (ES), University of Campania "Luigi Vanvitelli" (IT), University of L'Aquila (IT), Jahra Hospital (KW), Monash Medical Centre (AU), University of Chieti-Pescara (IT), BioCruces Health research Institute (ES), Ospedale di Cattinara (IT), Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (MX), Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT), Azienda Ospedaliera Universitaria Senese (IT), Hospital de Cruces (ES), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (BR), Policlinico San Matteo Fondazione (IT), Minia University Hospital (EG), University of Florence (IT), Post Graduate Institute of Medical Education and Research (IN), University of Bari Aldo Moro (IT), Monash University (AU), Hacettepe University (TR), Universitat de Barcelona (ES), University of Brescia (IT), Sapienza University of Rome (IT), University of Sousse (TN), Universidad del Rosario (CO)
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Ocular Diseases and Behçet’s Syndrome
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