Posters

Ocular complications and mortality in peripheral ulcerative keratitis and necrotising scleritis: the role of systemic immunosuppression

Poster Details

First Author: S.Ogra UK

Co Author(s):    R. Niederer   J. Sims   C. McGhee              

Abstract Details

Purpose:

To examine the clinical characteristics of subjects with peripheral ulcerative keratitis (PUK) and necrotising scleritis.

Setting:

Greenlane Eye Clinic, a large dedicated tertiary Ophthalmic centre based in Auckland, New Zealand.

Methods:

Retrospective analysis of all presentations to Auckland District Health Board with PUK, necrotising scleritis or scleritis associated with corneal infiltrates from 1998 onwards. Outcome measures included moderate visual loss (≤6/15 =MVL), severe visual loss (≤6/60=SVL) and mortality.

Results:

52 eyes of 41 subjects were included with mean follow up of 7.0 ± 5.3 years. Mean age was 51.3 ±18.6 years and 23 subjects (56.1%) were female. 12 subjects had a systemic diagnosis at presentation, increasing to 21 by final follow-up(51.2%). Recurrence occurred in 23 eyes (44.2%). MVL occurred in 10 eyes (19.2%) and SVL in 6 eyes (11.5%). 5 subjects (12.2%) died during the study. Immunomodulatory therapy (IMT) was used in 27 subjects (65.9%). A marked difference in survival was observed between those treated without IMT (mean survival 10.7 years), compared to those on IMT (24.7 years, p=0.045).

Conclusions:

PUK and necrotising scleritis represent a severe inflammatory disease with high rates of perforation, visual loss and mortality. IMT was associated with a lower rate of mortality in this group.

Financial Disclosure:

None