Treatment of Scleritis in Wegener's Granulomatosis (Granulomatosis with Polyangiitis)
When scleritis occurs in the setting of Wegener's granulomatosis (granulomatosis with polyangiitis), the underlying systemic vasculitis directly determines the treatment strategy. Standard ocular anti-inflammatory measures alone are insufficient in this context.
Clinical scenario
Scleritis presenting in a patient with known or concurrent Wegener's granulomatosis (granulomatosis with polyangiitis). The systemic autoimmune nature of the disease requires a treatment approach that addresses both the scleral and underlying inflammatory process.
Treatment goal
Control of scleral inflammation — relief of pain and reduction of damage to the eye.
Approach (partial summary)
Management in this setting requires systemic immunosuppressive therapy. The specific agent selection, sequencing, and monitoring parameters are detailed in the full structured protocol below.
References
DOI: 10.1016/j.survophthal.2005.04.001
- Patients with Wegener's granulomatosis may require cyclosphosphamide or mycophenolate, and chlorambucil is rarely used today.
- The aim of treatment is to remove or treat the cause where possible but in the majority is to control the inflammatory process to relieve the pain and thereby reduce the damage to the eye.
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