A case of giant nodular posterior scleritis mimicking choroidal malignancy

Liu, Andrea T.; Luk, Franklin T.; Chan, Carmen K. M.

doi:10.4103/0301-4738.176038

Cited by 21 publications

(18 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Due to its low incidence and variable clinical presentation, the mechanism underlying PS remains unclear and the majority of the research to date has focused instead on characterizing its clinical features, and optimizing diagnosis, treatment, and patient outcome [2][3][4]. Based on the anatomical location, PS presents with a range of clinical features, especially in fundus change, and, therefore, is often misdiagnosed as intraocular inflammation [5], ocular tumors [6], or orbital inflammation [7]; such misdiagnoses [8] increase the likelihood of incurring irreversible visual damage including eventual vision loss. Given the high rates of retinal detachment in PS [4], this condition can be easily misdiagnosed as central serous chorioretinopathy (CSC), which is characterized by retinal detachment in or around the macula.…”

Section: Introductionmentioning

confidence: 99%

The clinical features of posterior scleritis with serous retinal detachment: A retrospective clinical analysis

Dong

Gan

Zhang

et al. 2018

Preprint

View full text Add to dashboard Cite

Objective: To summarize the clinical features, systemic associations, risk factors and choroidal thickness(CT) changing in posterior scleritis (PS) with serous retinal detachment. Methods: This retrospective study included 23 patients with PS with retinal detachment from August 2012 to July 2017. All patients were documented with the Medical history and clinical features were recorded. The examinations included best corrected visual acuity (BACV), intraocular pressure（IOP）, fundus examination, routine eye examinations. Posterior coats thickness (PCT) was determined by B scan Ultrasound, the CT was measured by enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT). And clinical data were compiled and analyzed. Results: After application of extensive exclusion criteria, 23 patients with PS remained (13 females, 10 males). The average age at presentation was 29.5 ± 9.24 years old. Ocular pain and blurred vision were the two most common symptoms complained by patients. Anterior scleritis occurred in 12 patients, which was confirmed by Ultrasound Biomicroscopy (UBM) examination. Despite all patients displaying serous retinal detachment in their macula, no fluorescein leakage was observed in the macular. Optic disc swelling was documented in 10 of the 23 eyes. From B-scan ultrasound examination, the PCT increased with fluid in Tenon’s capsule demonstrated as a typical T-sign. The average PCT was 2.51 ± 0.85 mm in the PS-affected eye and only 1.09 ± 0.29 mm in the unaffected eye; this difference reached statistical significance. The subfoveal CT increased to an average of 442.61 ± 55.61μm, which correlated with axis length and PCT, but not with IOP. The BCVA and IOP did not correlate with either CT or the PCT. Conclusions: PS with serous retinal detachment presented with a variety of symptoms, such as pain and visual loss, and physical indicators. Typical T-sign detected by B-scan ultrasound was a useful confirmatory sign for PS diagnosis. Pathological increases in CT might be a potential predictive factor for inflammation.

show abstract

Section: Introductionmentioning

confidence: 99%

The clinical features of posterior scleritis with serous retinal detachment: A retrospective clinical analysis

Dong

Gan

Zhang

et al. 2018

Preprint

View full text Add to dashboard Cite

show abstract

“…However, it is sometimes difficult to distinguish between the two, and we usually hesitate to increase the amount of corticosteroid administered in such cases. Liu et al reported that a patient with a lesion similar to the one in our case improved with a nonsteroidal anti-inflammatory drug (NSAID) [ 11 ]. Since it is thought that NSAIDs produce fewer side effects than corticosteroids, it might also be better to try NSAID administration in our present case.…”

Section: Discussionmentioning

confidence: 93%

A case of scleritis associated rheumatoid arthritis accompanying an intraocular elevated lesion

et al. 2018

View full text Add to dashboard Cite

BackgroundScleritis and/or uveitis sometimes accompanies patients who suffer from rheumatoid arthritis. However, few studies have reported scleritis and/or uveitis accompanying a fundus elevated lesion, such as an intraocular tumor. In this study, we report a case of rheumatoid uveitis associated with an intraocular elevated lesion.Case presentationA 66-year-old female visited another eye clinic and was diagnosed as bilateral anterior uveitis, and was prescribed steroid eye drops for treatment. She had previously been diagnosed as rheumatoid arthritis at the age of 30 years. Due to vitreous opacity that appeared in her right eye, we increased the instillation of steroid eye drops and the amount of oral prednisolone. Although the inflammation had improved, anterior uveitis relapsed, and an intraocular whitish elevated lesion resembling an intraocular tumor at the superior nasal retina appeared. We speculated this lesion to be a granuloma complicated with rheumatoid arthritis. Thus, we increased the amount of prednisolone administration, and the lesion began to shrink and ultimately fully disappeared.ConclusionsWe strongly believe that our case’s lesion was a subretinal granuloma related with rheumatoid arthritis, as it disappeared by increased corticosteroid treatment. Our findings show that we should consider rheumatoid arthritis in a differential diagnosis of such types of fundus elevated lesions.

show abstract

“…[ 7 ] A trial of corticosteroid or non-steroidal anti-inflammatory drugs (NSAIDs) can differentiate masquerading scleritis of uveal melanoma from posterior scleritis with likelihood of resolution of mass following treatment with the latter. [ 8 9 ] Our patient was treated with topical and systemic steroid, which improved the secondary scleritis and exudative retinal detachment. Though it did not shrink the choroidal mass, the tumor appeared more solid and well organized, supporting the diagnosis of choroidal melanoma.…”

Section: Discussionmentioning

confidence: 97%