Posterior scleritis

Case contributed by Dr Dalia Ibrahim

Presentation

Known patient of systemic lupus presented with acute onset bilateral orbital pain, swelling and diminution of vision. Fundus examination revealed serous retinal detachment.

Patient Data

Age: 15 years
Gender: Male
MRI

Focal posterior scleral thickening and enhancement, associated with periscleral edema and preseptal edema.

Annotated image

Posterior scleral thickening and enhancement (Red arrows)

Periscleral edema (Blue arrow)

Preseptal edema (Yellow arrows)

Case Discussion

Diagnosis was confirmed by Ultrasonography and the patient improved after systemic steroid treatment.

Scleritis is a rare, underdiagnosed vision-threatening condition.

The etiology of scleritis is mainly inflammatory noninfectious, either idiopathic or in the context of systemic disease (e.g. rheumatoid, systemic lupus, granulomatosis with polyangiitis or Behçet).

Ultrasonography remains the criterion standard in diagnostic imaging of this condition.

CT and MRI also play an important role in diagnosis, radiological features include:

  • scleral thickening end enhancement
  • periscleral edema

Treatment: using nonsteroidal anti-inflammatory drugs or steroids.

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Case information

rID: 73837
Published: 24th Jan 2020
Last edited: 28th Jan 2020
System: Head & Neck
Inclusion in quiz mode: Included

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