A 48-year-old woman with rheumatoid arthritis of 10 years of evolution in treatment with lefluid, erythema multiforme and non-steroidal anti-inflammatory drugs (NSAIDs), was referred to our unit for worsening pain and remission.
The initial visual acuity was 0.6 in right eye (OD) and 1 in left eye (LE).
The biomycosis highlighted vascular engorgement with edema and superior temporal scleral thickening in the right eye compatible with the diagnosis of severe diffuse anterior scleritis.
The rest of the exploration was normal in OA.
Oral steroid treatment was started with prednisone at a dose of 1 mg/kg/day, maintaining the rest of the treatment, without obtaining clinical improvement after three weeks of follow-up.
Once the chest X-ray and a negative TST were performed, it was decided to administer Infliximab®, intravenous Schtoux/Plough, UK at 3-week intervals Garden City.
After the second dose, a reduction in vascular engorgement and scleral edema was observed, and after the third dose, complete disappearance of scleral inflammation was achieved, with some transparency of the underlying residual uveal tissue remaining.
At the same time, there was an improvement in joint signs and symptoms, with a decrease in the overall disease activity represented by the Disease Activity Score (DAS 28), with a 40% improvement in DAS 28.
After a 6-month follow-up period, no recurrences in scleral inflammation were detected.
Visual acuity is 1 in both eyes (OA).
Currently, the patient is on systemic treatment with prednisone 7.5 mg/day, aspirin and NSAIDs only.
