Bilateral Posterior Scleritis: Analysis of 18 Cases from a Large Cohort of Posterior Scleritis

Purpose: To describe the clinical and epidemiological characteristics of patients and analyze factors associated with bilateral posterior scleritis.Methods: In this retrospective cohort study, records of patients with diagnosis of bilateral posterior scleritis at two tertiary-care centers in the UK and India were analyzed in comparison with the clinical profile of patients with unilateral scleritis.Results: In total, 18 patients with bilateral posterior scleritis were identified and compared with 96 patients of unilateral posterior scleritis; 14 (77%) were women and the median age was 48 years. Headache (p = 0.04), optic nerve swelling (p = 0.01), and elevated antinuclear antibodies (ANA) titers (p = 0.03) were present more frequently in patients with bilateral than in unilateral posterior scleritis. Seven patients (38.88%) required immunosuppressive therapy to attain resolution of the inflammation and to prevent relapse.Conclusions: Bilateral posterior scleritis is an uncommon but severe inflammation of the posterior sclera. The majority of them are idiopathic, often requiring aggressive treatment to prevent visual loss.