Penatalaksanaan Skleritis

Oleh :

dr. Felicia

Tujuan utama penatalaksanaan skleritis adalah untuk mengurangi nyeri dan mencegah terjadinya komplikasi okular maupun sistemik. Penatalaksanaan skleritis bergantung dari etiologi yang mendasari. Penentuan etiologi infeksius maupun noninfeksius sangat perlu dibedakan, karena penatalaksanaan yang diberikan berbeda.[2]

Penatalaksanaan skleritis bertujuan untuk menghambat proses inflamasi yang terjadi, sehingga tidak terjadi penipisan sklera dan kerusakan struktur okular. Secara umum, penatalaksanaannya meliputi pemberian analgesik, kortikosteroid, dan agen imunosupresi.

Agen imunosupresi disarankan terutama pada necrotizing scleritis. Pada skleritis yang disebabkan karena infeksi, pemberian antibiotik atau antivirus sesuai dengan mikroorganismenya juga diperlukan.[1,7,15,16]

Skleritis merupakan penyakit yang biasanya tidak berdiri sendiri, sehingga penatalaksanaan skleritis perlu dibarengi dengan penatalaksanaan penyakit yang menyertainya.

Referensi

1. Yoshida A, Watanabe M, Okubo A, et al. Clinical characteristics of scleritis patients with emphasized comparison of associated systemic diseases (anti-neutrophil cytoplasmic antibody-associated vasculitis and rheumatoid arthritis). Jpn J Ophthalmol. 2019 Sep;63(5):417–24.
2. Nevares A, Raut R, Libman B, et al. Noninfectious Autoimmune Scleritis: Recognition, Systemic Associations, and Therapy. Curr Rheumatol Rep. 2020 Apr;22(4):11.
5. Valenzuela FA, Ocular Surface Center, Bascom Palmer Eye Institute, University of Miami, Florida, US, Perez VL, Ocular Surface Center, Bascom Palmer Eye Institute, University of Miami, Florida, US. Scleritis—Infectious Versus Inflammatory. US Ophthalmic Rev. 2016;09(02):92.
6. Siatiri H, Mirzaee-Rad N, Aggarwal S, et al. Combined tenonplasty and scleral graft for refractory Pseudomonas scleritis following pterygium removal with mitomycin C application. J Ophthalmic Vis Res. 2018;13(2):200–2.
7. Quist TS, Vogelgesang S, Goins KM. Scleritis: A Case Report and Overview. Ophthalmol Vis Sci - Univ Iowa Health Care. 2018 Nov 16; https://webeye.ophth.uiowa.edu/eyeforum/cases/281-scleritis.htm
13. Gan YK, Ahmad SS, Alexander SM, et al. Acute anterior necrotizing scleritis: A case report. J Acute Dis. 2016 Sep 1;5(5):439–41.
14. Galor A, Thorne JE. Scleritis and Peripheral Ulcerative Keratitis. Rheum Dis Clin North Am. 2007 Nov;33(4):835–54.
15. Stem MS, Todorich B, Faia LJ. Ocular Pharmacology for Scleritis: Review of Treatment and a Practical Perspective. J Ocul Pharmacol Ther. 2017 Mar 29;33(4):240–6.
16. Djordjević-Jocić J, Janković-Veličković L, Cekić S, et al. Clinicopathologic Analysis of “Idiopathic” Scleritis and Scleritis Associated with Rheumatoid Arthritis -mini Review. Acta Medica Median. 2019;8.
17. Yelumalai M, Tharmathurai S. Tubercular Scleritis: A Case report. Int J Sci Res Publ IJSRP. 2019 Mar 6;9(3):p8744.
18. Oray M, Meese H, Foster CS. Diagnosis and management of non-infectious immune-mediated scleritis: current status and future prospects. Expert Rev Clin Immunol. 2016 Aug 2;12(8):827–37.
19. Sari N. Kelainan Mata pada Pasien Kusta. MDVI. 2018 Apr;45:59–115.
20. Paul L, Agarwal M, Singh S, et al. Tuberculous scleritis in a young Asian Indian girl—a case presentation and literature review. J Ophthalmic Inflamm Infect. 2019 Dec 23;9(1):22.
21. Moreira-Neto C, Moreira Jr. C, Tolentino D, et al. Nodular posterior scleritis associated with presumed ocular tuberculosis: A multimodal imaging case report. Am J Ophthalmol Case Rep. 2019 Dec 1;16:100558.
24. Gupta A, Anchal Thakur MS. Surgically Induced Necrotizing Scleritis. In: Gupta V, Nguyen QD, LeHoang P, Herbort CP, editors. The Uveitis Atlas. New Delhi: Springer India; 2016. p. 1–6. http://link.springer.com/10.1007/978-81-322-2506-5_110-1
25. Sims J. Scleritis: presentations, disease associations and management. Postgrad Med J. 2012 Dec;88(1046):713–8.
37. Cunningham ET, McCluskey P, Pavesio C, et al. Scleritis. Ocul Immunol Inflamm. 2016 Jan 2;24(1):2–5.
38. Charanya C, Swathi A, Janti S, et al. Ocular Manifestation in Rheumatoid Arthritis Patients Presenting to Tertiary Care Hospital in South India: A Prospective Study. 2015;3(8):6.
47. American Academy of Ophthalmology (AAO). Scleritis and Episcleritis: Treatment. 2019. https://www.aao.org/focalpointssnippetdetail.aspx?id=2066dce6-0b27-4be1-9e82-f550369a5d3c
48. Rossi DC, Ribi C, Guex-Crosier Y. Treatment of chronic non-infectious uveitis and scleritis. Swiss Med Wkly. 2019 Mar 10;149(0910). https://smw.ch/article/doi/smw.2019.20025
49. Boston LMR MD. Posterior Scleritis: A Diagnostic Challenge. 2018. https://www.reviewofophthalmology.com/article/posterior-scleritis-a-diagnostic-challenge
50. Maza MS de la, Molina N, Gonzalez-Gonzalez LA, et al. Scleritis Therapy. Ophthalmology. 2012 Jan 1;119(1):51–8.
51. Agarwal AM, Majumder PD. Tubercular posterior scleritis: A case report and review of literature. Indian J Ophthalmol. 2019 Aug 1;67(8):1362.
52. Ram R. Tectonic corneal lamellar grafting for surgically-induced necrotizing scleritis after strabismus surgery: Case report & literature review. Am J Ophthalmol Case Rep. 2018 May 1;11:28–31.
53. Shenoy R, Suryawanshi M, Isaac R, et al. Posterior scleritis in pediatric age group: A case report and review of literature. Oman J Ophthalmol. 2016;9(1):59–62.
54. Comacchio F, Cecchin V, Martini G, et al. Posterior Scleritis in a Teenager Responding to Abatacept. 2018;4.
55. Pal N S, Korir F. SCITECH - Scleral Patch Graft with Fibrin Adhesive for Post Pterygium Scleral Thinning - International Journal of Clinical Case Studies and Reports (ISSN:2641-5771). Int J Clin Case Stud Rep. 2019 Jan 13;1(1):8–9.

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Referensi

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