Clinical Profile of Patients with Necrotizing Scleritis in a Tertiary Eye Care Center in Southern India

PURPOSE: To report the clinical profile of a series of necrotizing scleritis in an Indian population. METHODS: A retrospective medical record review of 27 consecutive patients with necrotizing scleritis. Patient demographics, ocular and systemic findings, treatment modalities, and visual outcome were recorded. RESULTS: There were 19 males and 8 females (31 eyes) with mean age at presentation of 49.5 years (range: 30-84 years). Underlying immunologically induced disorders was present in 37%. In 70% of the cases with immunologically induced disorders, necrotizing scleritis was the initial presentation. Complicated cataract (25.8%) and exudative retinal detachment (9.6%) were the most common anterior and posterior segment complications, respectively. Cyclophosphamide was the most commonly used immunosuppressive (55.56%) and proved to be the most effective. But even with the best available treatment, globe perforation was encountered in two eyes. CONCLUSIONS: Necrotizing scleritis can be the initial presentation of immunologically induced disorders. This disease entity is plagued with a high rate of ocular complications, especially those which can be devastating, such as globe perforation. Early and intensive therapy can be helpful in salvaging the eye.