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Query: UMLS:C0851184 (thinning)
 11,252 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Autogenous periosteum was used to reinforce scleral thinning, perforation, or corneoscleral wound dehiscence in four eyes of three patients with necrotizing scleritis or peripheral ulcerative keratitis associated with advanced rheumatoid arthritis. All grafts have remained intact during an average follow-up interval of 36 months (range, 19-52 months). The postoperative visual acuity ranged between 20/30-20/60. Two eyes exhibited age-related macular degeneration, and one eye had an epiretinal membrane postoperatively. No systemic complications occurred following surgery.
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PMID:Long-term follow-up study of scleroplasty using autogenous periosteum. 232 82

We examined three patients who had dermatologic and biochemical manifestations of porphyria cutanea tarda and localized thinning or excavation in the sun-exposed interpalpebral sclera, adjacent to the cornea. All three patients had signs of acute scleritis. The acute scleritis responded to oral indomethacin in one patient, but systemic corticosteroids were required to control the inflammation in the other two patients. Phlebotomy, protection from sunlight, and refraining from alcohol played an important part in the treatment of the patients.
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PMID:Acute scleritis in porphyria cutanea tarda. 233 Sep 42

Although systemic immunosuppressive chemotherapy is effective in halting progressive necrotizing scleritis, the onset of its action may be too slow to prevent profound scleral thinning and/or traumatic or spontaneous perforation. Scleral homografts may be used to maintain the integrity of the globe until immunosuppressive drugs can take effect. The authors reviewed their experience with scleral homografts in 12 patients with progressive necrotizing scleritis; eight (all with autoimmune disease) had concomitant chemotherapy and four (two with autoimmune disease) did not. Grafts remained stable in patients receiving both surgical and drug therapy over a mean follow-up of 12 months. One graft melted after discontinuation of chemotherapy, but regrafting and renewed immunosuppression salvaged the eye. Grafts in two of the patients not initially given chemotherapy melted rapidly (within 14 and 45 days, respectively). Both eyes were salvaged by regrafting and/or addition of chemotherapy. Though rarely successful by itself against necrotizing scleritis, scleral grafting is a useful adjunct to chemotherapy.
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PMID:Scleral grafting for necrotizing scleritis. 271 May 20

The ocular and systemic findings in 112 Mayo Clinic patients with relapsing polychondritis were reviewed. The incidence of males and females was equal, with median age at diagnosis of 51 years and the median follow-up of 6 years. Most patients had several organ systems involved at the time of the diagnosis. Twenty-one patients had ocular symptoms at the onset, and 57 developed ocular symptoms during their course. Major ocular complications included proptosis, lid edema, episcleritis/scleritis, corneal infiltrates/thinning, iridocyclitis, retinopathy, and optic neuritis. The major system involvement included otorhinolaryngeal, respiratory, arthritic, renal, cardiovascular, dermatologic, and neurologic diseases. Generally, laboratory studies were not helpful in making the diagnosis but were valuable in monitoring the disease. Based on the experience in these cases, the indications for the various therapeutic modalities are offered.
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PMID:Ocular and systemic findings in relapsing polychondritis. 352 58

In a prospective study of 325 patients with adult rheumatoid arthritis, ocular complications were seen in 73 patients (22.4%). Keratoconjunctivitis sicca was the most common ocular lesion. Other lesions were episcleritis, scleritis, marginal thinning of the cornea with keratolysis, stromal corneal opacities with peripheral vascularisation, and iridocyclitis. The mean duration of the arthritis and the mean duration of seropositivity were found to be significantly higher in patients with ocular complications. Physicians should include ophthalmic examination as a routine in their protocol for patients with rheumatoid arthritis to facilitate early diagnosis and treatment of ocular complications.
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PMID:Ocular complications of adult rheumatoid arthritis. 885 25

We present a case of misdiagnosed and inadequately treated necrotizing scleritis leading to ocular complications. Scleral thinning and a marked secondary corneal astigmatism were observed and measured by ultrasound biomicroscopy and corneal topography. The purpose of this case report is to demonstrate the clinical value of additional diagnostic tools, such as ultrasound biomicroscopy and corneal topography and to alert ophthalmologists as to the complications of necrotizing scleritis.
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PMID:Complications of misdiagnosed and inadequately treated necrotizing scleritis studied by ultrasound biomicroscopy and computerized corneal topography. 929 21

A 74-year-old patient sought treatment for visual obscuration and clinically had signs of Graves orbitopathy. Past medical history was unremarkable except for the use of antihypertensive medication. During the hospital admission, a fluorescent treponemal antibody absorption test was reactive, indicating infection with syphilis at some time in the past. Visual deterioration despite oral corticosteroid therapy prompted orbital decompression. At the time of surgery, she sustained a globe rupture. Presumably, syphilitic scleritis was responsible, in part, for scleral thinning and weakening, predisposing her to this complication. To the authors' knowledge, globe rupture has not been previously reported during orbital decompression.
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PMID:Ruptured globe during orbital decompression surgery. 978 85

The purpose of this report is to describe the effective treatment of severe anterior segment inflammation due to Cogan syndrome through the use of topical administration of cyclosporin A. A 47-year-old female patient had been experiencing headaches and difficulties with her vision. Subsequent examination revealed the sudden onset of bilateral conjunctival injection and swelling of bilateral auricles. Despite the multiple treatment (systemic and topical corticosteroid and antibiotic therapy), necrotizing scleritis had appeared bilaterally and the scleral wall was thinning. Topical administration of 1% cyclosporin A was applied to both eyes 4 times a day. After 2 months of this therapy, the epithelial tissue covered the necrotizing tissue and her symptom of ocular pain was relieved and her corrected visual acuity was improved. This is the first case exhibiting that topical cyclosporin A is an effective treatment for severe anterior segment inflammation associated with Cogan syndrome.
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PMID:Effective treatment with topical cyclosporin A of a patient with Cogan syndrome. 1105 5

Although the ganciclovir implant is an effective and well-tolerated treatment for cytomegalovirus retinitis in patients with human immunodeficiency virus infection, complications that may occur include retinal detachment, implant extrusion, and endophthalmitis. A 22-year-old woman with human immunodeficiency virus infection presented with a painful left eye with scleritis overlying previous ganciclovir implant sclerotomy sites. The inflammation progressed 360 degrees around the pars plana with progressive thinning at the implant sites. Post-surgical necrotizing scleritis is another complication that can occur in patients with ganciclovir implants.
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PMID:Post-surgical scleritis associated with the ganciclovir implant. 1518 97

A 23-year-old Chinese woman presented with necrotizing scleritis 10 months after diode laser cyclophotocoagulation for the treatment of her neovascular glaucoma. There were areas of scleral thinning with uveal prolapse in the superior quadrant. The inflammation and progression of the staphyloma were controlled with systemic steroids. Diode laser cyclophotocoagulation may not be safe in patients suspected to have underlying systemic vasculitic diseases.
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PMID:Necrotizing scleritis following diode laser transscleral cyclophotocoagulation. 1518 96


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