{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:21:37Z","timestamp":1787761297820,"version":"build-2784847793"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To describe the clinical features and management of patients with scleritis associated with granulomatosis with polyangiitis (GPA) at a tertiary eye care center in South India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The clinical profile and management of patients presenting to a tertiary eye care center in South India with scleritis secondary to GPA from 2003 to 2021 were analyzed retrospectively. Scleritis was classified into anterior diffuse, nodular, and necrotizing scleritis with inflammation according to Watson and Hayreh\u2019s classification. Demographic characteristics, clinical features, anti-neutrophil cytoplasmic antibody (ANCA) positivity, treatment response, ocular complications, and status at the last follow-up were analyzed. Statistical analysis of data was performed using Microsoft Excel 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Nineteen eyes of 17 patients (15 cytoplasmic staining ANCA [c-ANCA], two p-ANCA positive) were included. Fifteen eyes had necrotizing scleritis, two had diffuse anterior scleritis, and two had nodular scleritis. Remission was induced using a combination of steroids and cyclophosphamide or rituximab. Maintenance therapy was instituted using tapering steroids and immunosuppressants like cyclophosphamide, mycophenolate mofetil, methotrexate, or rituximab. Three eyes required a scleral patch graft. Fourteen patients had good anatomical and visual outcomes, and three were lost to follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>GPA is a rare disease, while it is the most common ANCA-associated vasculitis with scleritis. As scleritis may be the presenting sign of the disease, ophthalmologists must be aware of the various features suggestive of GPA. GPA-associated scleritis can have a good prognosis when diagnosed promptly and managed aggressively in the acute stage, and remission is maintained with adequate systemic immunosuppression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_1411_22","type":"journal-article","created":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T09:14:27Z","timestamp":1672910067000},"page":"146-152","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Clinical profile and management of granulomatosis with polyangiitis\u2013associated scleritis from a tertiary care hospital in South India"],"prefix":"10.4103","volume":"71","author":[{"given":"Amanda","family":"Mohanan-Earatt","sequence":"first","affiliation":[{"name":"Department of Uveitis and Ocular Pathology, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyotirmay","family":"Biswas","sequence":"additional","affiliation":[{"name":"Department of Uveitis and Ocular Pathology, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,12,30]]},"reference":[{"key":"R1-20240828","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/j.survophthal.2005.04.001","article-title":"Scleritis","volume":"50","author":"Okhravi","year":"2005","journal-title":"Surv Ophthalmol"},{"key":"R2-20240828","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.ophtha.2011.07.013","article-title":"Clinical characteristics of a large cohort of patients with scleritis and episcleritis","volume":"119","author":"Sainz de la Maza","year":"2012","journal-title":"Ophthalmology"},{"key":"R3-20240828","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1016\/j.autrev.2014.08.017","article-title":"Granulomatosis with polyangiitis (Wegener):Clinical aspects and treatment","volume":"13","author":"Comarmond","year":"2014","journal-title":"Autoimmun Rev"},{"key":"R4-20240828","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1007\/s10238-018-0492-7","article-title":"Granulomatosis with polyangiitis:Clinical course and outcome of 60 patients from a single center in South India","volume":"18","author":"Shobha","year":"2018","journal-title":"Clin Exp Med"},{"key":"R5-20240828","first-page":"1025","article-title":"Wegener's granulomatosis:The relationship between ocular and systemic disease","volume":"28","author":"Harper","year":"2001","journal-title":"J Rheumatol"},{"key":"R6-20240828","doi-asserted-by":"crossref","first-page":"61","DOI":"10.5582\/irdr.2016.01014","article-title":"Granulomatosis with polyangiitis (Wegener's disease):An updated review of ocular disease manifestations","volume":"5","author":"Kubaisi","year":"2016","journal-title":"Intractable Rare Dis Res"},{"key":"R7-20240828","doi-asserted-by":"crossref","first-page":"488","DOI":"10.7326\/0003-4819-116-6-488","article-title":"Wegener granulomatosis:An analysis of 158 patients","volume":"116","author":"Hoffman","year":"1992","journal-title":"Ann Intern Med"},{"key":"R8-20240828","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.injr.2015.08.001","article-title":"Granulomatosis with polyangiitis:Indian experience","volume":"10","author":"Kumar","year":"2015","journal-title":"Indian J Rheumatol"},{"key":"R9-20240828","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1136\/bjo.65.8.553","article-title":"Ocular changes in limited forms of Wegener's granulomatosis","volume":"65","author":"Spalton","year":"1981","journal-title":"Br J Ophthalmol"},{"key":"R10-20240828","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.autrev.2019.03.001","article-title":"Ocular involvement in granulomatosis with polyangiitis:A single-center cohort study on 63 patients","volume":"18","author":"P\u00e9rez-Jacoiste As\u00edn","year":"2019","journal-title":"Autoimmun Rev"},{"key":"R11-20240828","first-page":"217","article-title":"Ocular manifestations of Wegener's granulomatosis. 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