Incidence and Outcome of Cataract in Eyes with Scleritis and Episcleritis

Michelle J. Sun, Kellogg Eye Center, University of Michigan, Ann Arbor, Massachusetts, USA.
Bernard A. Rosner, Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Craig W. Newcomb, Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Kurt A. Dreger, Department of Population, Family, and Reproductive Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Pichaporn Artornsombudh, Department of Ophthalmology, Somdech Phra Pinklao Hospital, Royal Thai Navy, Bangkok, Thailand.
Srishti Kothari, Scheie Eye Institute, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Abhishek R. Payal, Mahatme Eye Bank Eye Hospital, Nagpur, India.
Siddharth S. Pujari, Siddharth Netralaya Superspecialty Eye Hospital, Belgaum, India.
Grace A. Levy-Clarke, Department of Ophthalmology and Visual Sciences, West Virginia University, Morgantown, West Virginia, USA.
H Nida Sen, Department of Ophthalmology, George Washington University, Washington, District of Columbia, USA.
Eric B. Suhler, Department of Ophthalmology, Oregon Health and Science University, Portland, Oregon, USA.
Jennifer E. Thorne, Department of Ophthalmology, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Nirali P. Bhatt, Scheie Eye Institute, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
C Stephen Foster, Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts, USA.
Douglas A. Jabs, Department of Ophthalmology, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
James T. Rosenbaum, Department of Ophthalmology, Oregon Health and Science University, Portland, Oregon, USA.
Jeanine M. Buchanich, Center for Occupational Biostatistics and Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA.
Sylvia L. Groth, Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Gui-Shuang Ying, Scheie Eye Institute, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Sapna S. Gangaputra, Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
John H. Kempen, Kellogg Eye Center, University of Michigan, Ann Arbor, Massachusetts, USA.

Document Type

Journal Article

Publication Date

2-12-2025

Journal

Ocular immunology and inflammation

DOI

10.1080/09273948.2025.2453878

Keywords

Scleritis; cataract; episcleritis; surgery; visual outcome

Abstract

PURPOSE: To estimate the incidence and predictive factors for cataract in eyes with episcleritis and scleritis, and to evaluate the outcome of cataract surgery in those eyes. DESIGN: Retrospective cohort study at uveitis subspecialty centers. METHODS: One thousand three hundred eighty-four eyes with non-infectious scleritis and episcleritis at risk of cataract were included. Predictive factors for cataract development were assessed by multivariable Cox regression. The main outcomes were development of cataract, defined as the first reduction of presenting visual acuity <20/40 attributed to cataract or else occurrence of cataract surgery itself. A second cohort of eyes with episcleritis and scleritis that underwent cataract surgery was evaluated for postoperative outcomes. Logistic regression was utilized to assess variables associated with visual acuity 20/40 or better one year after cataract surgery. RESULTS: Seventy-six eyes developed cataract (incidence = 0.025/eye-year, 95% confidence interval: 0.019-0.031). Age ≥65 years, elevated intraocular pressure ≥30 mmHg, use of oral corticosteroids at the preceding visit, and anterior chamber inflammatory activity were associated with increased cataract incidence. Race/ethnicity, type of scleritis, and bilaterality were unassociated with cataract risk after adjustment. Among 79 cataractous eyes that underwent cataract surgery, median presenting visual acuity improved by 6 ETDRS lines. Pre-operative factors including duration of inflammation, immunotherapy use, and corticosteroid use were not significantly associated with odds of post-operative visual acuity 20/40 or better. CONCLUSIONS: Under subspecialty management, the incidence of cataract was low in eyes with episcleritis and scleritis. Cataract surgery was associated with large and sustained improvements in visual acuity.

Department

Ophthalmology

Link to Full Text

Share

COinS