Presentation Of Posterior Scleritis Research Articles

A case of posterior scleritis presenting as unilateral secondary angle-closure glaucoma

A case of posterior scleritis presenting as unilateral secondary angle-closure glaucoma

Posterior Scleritis Mimicking Orbital Cellulitis: A Report of the Three Cases

Objective: To report on three cases of posterior scleritis presenting as orbital cellulitis. Case Report: The authors retrospectively reviewed the medical records of three patients who were diagnosed as posterior scleritis but initially presented as orbital cellulitis. All patients were young males who presented with pain, unilateral proptosis, eyelid swelling with redness, and limitation of ocular movement. Initially, the diagnosis of orbital cellulitis was suspected and patients had been treated with systemic antibiotics but with no clinical improvement. Systemic work-up for infections and autoimmune diseases were negative. The orbital computed tomography (CT) scans showed severe posterior eyewall thickening with associated soft tissue edema. Ultrasonography showed a typical T-sign, compatible with posterior scleritis. Specific cause of scleritis or an association with systemic disease was not established. Systemic corticosteroids (1 mg per kg per day) were administered, and all patients improved within several days. Conclusion: Posterior scleritis is a rare and severe ocular inflammatory disorder that can mimic orbital cellulitis. Early detection and prompt treatment is crucial. Keywords: Posterior scleritis, Orbital cellulitis, Non-specific orbital inflammation, Orbital computed tomography scan, T-sign ultrasonography

Bilateral Posterior Scleritis Presenting as the First Manifestation of Immunoglobulin A Nephropathy: Case Report and Review of the Literature

Purpose: We describe a case of posterior scleritis presenting as the first manifestation in a Chinese patient with immunoglobin A nephropathy (IgAN).Methods: Retrospective review of our patient and review of the published case reports from PubMed search.Results: A 43-year-old woman developed bilateral posterior scleritis. Microscopic hematuria and proteinuria was found by urinalysis, and a kidney biopsy revealed IgAN. The posterior scleritis was resolved with oral prednisolone. For the review, 12 cases of episcleritis (70.6%), 4 cases of scleritis (23.5%), and 1 case of posterior scleritis (5.9%) associated with IgAN were analyzed. Five patients (29.4%) had scleritis or episcleritis as the first presenting manifestation.Conclusions: Posterior scleritis may be the first manifestation of IgAN in a patient. For any adult patient with scleral/episcleral inflammation, urinalysis should be done to rule out IgAN.

Clinical Features and Presentation of Posterior Scleritis: A Report of 31 Cases

Purpose: To describe clinical features, ocular complications, and visual outcomes of patients with posterior scleritis.Methods: Clinical characteristics of a subset of 31 patients with posterior scleritis were studied and compared with 469 patients with anterior scleritis.Results: Of 500 patients, 31 (6.2%) had posterior scleritis. Most patients presented with subacute (80.6%), unilateral (61.3%) scleral inflammation. Pain was moderate to severe in 54.8% of patients. Concomitant anterior scleritis was observed during follow-up in 77.4% of patients and in all patients with moderate to severe pain. Patients with posterior scleritis were significantly younger (43.6 vs. 54.4 years, p < 0.001) and had significantly higher decrease of vision (29.0 vs. 14.9%, p = 0.027) than those with isolated anterior scleritis.Conclusions: Posterior scleritis must be considered in patients with decrease of vision, mild to severe pain, optic disc edema, and/or posterior uveitis. Moderate to severe pain may be associated with poorer visual outcome.

POSTERIOR SCLERITIS IN A 9-YEAR-OLD BOY: A CASE REPORT

To report a case of posterior scleritis in a 9-year-old boy. A case report. Uniocular presentation in a 9-year-old boy. Posterior scleritis is seen commonly in middle-aged women, associated with mild ocular congestion, globe tenderness, and varying amount of vision loss. We report an uncommon presentation of posterior scleritis in a young male child. The patient presented with decreased vision and extraocular and intraocular inflammatory signs in the left eye. Fundus examination showed disk and macular edema with a T-sign on B-scan ultrasound. The patient showed good response to oral steroids with resolution of inflammation and recovery of vision.

An Atypical Presentation of Posterior Scleritis

We report a case of an unusual presentation of posterior scleritis. A 13 year old girl presented with progressive monocular visual loss over one week. She did not complain of pain as a significant symptom. Examination of the fundus revealed a pale raised subretinal lesion temporal to the fovea with overlying exudative retinal detachment. A B-scan ultrasound confirmed choroidal and scleral thickening, retinal detachment and fluid in the sub-Tenon’s space. Fundus fluorescein angiography showed multiple areas of progressively increasing hyperfluorescence (leakage of dye) temporal to the fovea. Systemic evaluation of this patient did not reveal an underlying systemic disorder. The patient was commenced on high dose oral corticosteroids which resulted in resolution of symptoms and clinical features. She made full visual recovery after six weeks of treatment. This case illustrates an interesting presentation of posterior scleritis in a 13 year old and explores clinical features, treatment and prognosis in this age group.

Posterior scleritis presenting with simultaneous branch retinal artery occlusion and exudative retinal detachment

Posterior scleritis presenting with simultaneous branch retinal artery occlusion and exudative retinal detachment

Subretinal Mass as a Presenting Sign of Posterior Scleritis: A Case Report

We report a case of an unusual clinical presentation of posterior scleritis. A 40-year-old woman suffered from sudden blurred vision in her left eye for 1 day. She had no systemic or autoimmune diseases. Fundus examination revealed a subretinal mass (10.5 x 6 mm in basal diameter) in the nasal-superior quadrant extending from the optic disc to the periphery. Overlying retinal striae were obvious. Optic disc hyperemia and mild edema were noted. Fluorescein angiography did not show dye leakage or tumor-feeding vessels. Ultrasonography showed high internal reflectivity of the subretinal mass and thickened sclera with T-sign. Under the impression of posterior scleritis, corticosteroids and nonsteroidal anti-inflammatory drugs were given orally and topically. After 4 weeks, the subretinal mass disappeared without any sequelae. The patient recovered full vision. This case suggests that posterior scleritis is among the differential diagnoses for a fundus mass. There has been no other similar report in Taiwan.

Bilateral posterior scleritis

Purpose: To describe an unusual presentation of posterior scleritis in a healthy young patient. Method: We reviewed the medical record of 21 -year-old man for clinical presentation, course, and ancillary studies. Results: The healthy patient had a painless, bilateral posterior scleritis that presented with a combination of circumscribed fundus masses and exudative macular detachment. On fluorescein angiography, different hyperfluorescent patterns characterized the two manifestations of posterior scleritis. An ultrasound confirmed the scleral thickening. Fundoscopic abnormalities resolved with oral prednisone. Conclusion: Pain is not always present in this disease. A combination of exudative macular detachment and circumscribed fundus masses can be a form of presentation in posterior scleritis.