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Effectiveness of difluprednate in addition to systemic therapy for the treatment of anterior scleritis.
- Source :
-
The British journal of ophthalmology [Br J Ophthalmol] 2024 Jun 20; Vol. 108 (7), pp. 951-955. Date of Electronic Publication: 2024 Jun 20. - Publication Year :
- 2024
-
Abstract
- Aim: To describe the effectiveness and side-effect profile of adding difluprednate therapy to patients with anterior scleritis being treated systemically.<br />Methods: Retrospective chart review. Charts from all patients with anterior scleritis who were treated with topical difluprednate in addition to systemic therapy from 1 January 2018 to 1 January 2020 were reviewed. Data collected included: demographics, scleritis type, systemic diagnosis, presence of nodules or necrosis, changes in scleritis activity, intraocular pressure (IOP), number of difluprednate drops used, type of systemic treatment used, best-corrected visual acuity (BCVA) and lens status. The primary outcome was clinical resolution of scleritis. Secondary outcomes included BCVA loss ≥2 lines, change in lens status or cataract surgery and IOP ≥24 mm Hg.<br />Results: Thirty-two patients (44 eyes) were analysed. The median age was 57 years (IQR 52, 72); 59% were female; 72% were Caucasian. An associated systemic disease was present in 59%. Systemic therapies used when difluprednate was added were: 65% immunosuppressive agents, 43% prednisone and 25% non-steroidal anti-inflammatory drugs. The addition of difluprednate resulted in clinical resolution in 79.6% of the treated eyes. Median time to inactivity was 9 weeks (IQR 5, 20). Eyes initially using 2-4 drops per day had a higher response rate (89%, p=0.005). Over a median follow-up of 34 weeks (IQR 21, 74), 11 eyes had IOP elevation; 6 eyes lost ≥2 lines of BCVA, 5 eyes had cataract progression.<br />Conclusion: Most eyes treated with difluprednate achieved inactivity. The addition of difluprednate to systemic therapies provides an alternative to achieve control of inflammation.<br />Competing Interests: Competing interests: None declared.<br /> (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
- Subjects :
- Humans
Female
Middle Aged
Male
Retrospective Studies
Aged
Treatment Outcome
Immunosuppressive Agents therapeutic use
Ophthalmic Solutions
Drug Therapy, Combination
Follow-Up Studies
Scleritis drug therapy
Scleritis diagnosis
Scleritis physiopathology
Fluprednisolone analogs & derivatives
Fluprednisolone therapeutic use
Fluprednisolone administration & dosage
Visual Acuity physiology
Intraocular Pressure drug effects
Intraocular Pressure physiology
Glucocorticoids therapeutic use
Glucocorticoids administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1468-2079
- Volume :
- 108
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- The British journal of ophthalmology
- Publication Type :
- Academic Journal
- Accession number :
- 37666642
- Full Text :
- https://doi.org/10.1136/bjo-2022-322841