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Follow-Up of a Patient with Scleromalacia Perforans and Idiopathic Interstitial Pneumonia Liebow

Koop G., Schmidt W.,
Justus-Liebig-Universität Gießen, Zentrum für Augenheilkunde (Gießen)

Introduction: The necrotizing anterior scleritis (Scleromalacia perforans) is a disease fortunately rarely encountered in the ophthalmologists office. In affected patients, it is often threatening the visual acuity and due to the associated systemic disease found in about 50% of the patients, 30-45% die within 5 years after the illnes is first diagnosed.
Patient and Method: The case history of a now 70 year-old male patient with necrotizing anterior scleritis in the right eye and associated idiopathic interstitial pneumonia type Liebow has been documented for 12 years, including follow-up photographes and the given conservative and surgical therapy.
Case History: After the necrotizing scleritis had been diagnosed in 1990, the immunosuppressive therapy was started in cooperation with the rheumatologists. Despite ongoing therapy, which, due to complications, had to be changed several times, the patient needed 4 operations to cover recurring defects in the conjunctiva or sclera with homologues sclera or amnion-membrane and a cataract-operation. Until the last check-up in march 2002 these therapeutic measurements had been successful in preserving the eye with a visual acuity of 0.2.
Conclusions: In this case the preservation of the eyes visual acuity and a certain quality of life was successfully arcieved by interdisciplinary therapeutical cooperation.