Bilateral Posterior Scleritis Associated with Giant Cell Arteritis: A Case Report

Erdogan, Mehmet; Sayın, Nihat; Ekinci, Dilbade Yıldız; Bayramoğlu, Sadık Etka

doi:10.1080/09273948.2017.1343854

Cited by 12 publications

(5 citation statements)

References 9 publications

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“…However, this woman’s age, raised ESR and headache raised suspicion for GCA, as they correspond to three out of five diagnostic criteria for GCA 4. Bilateral posterior scleritis is rarely associated with GCA;4–6 however, evidently needs to be considered. Treatment for posterior scleritis includes topical or systemic non-steroidal anti-inflammatories and/or steroids, depending on severity of the disease 2 3.…”

Section: Discussionmentioning

confidence: 91%

Bilateral posterior scleritis due to giant cell arteritis

2022

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A woman aged mid 70s with mild learning difficulty presented with eye symptoms, headache and shoulder pains. She was found to have bilateral posterior scleritis secondary to giant cell arteritis. Posterior scleritis is a potentially blinding condition, with ambiguous symptoms and signs, therefore diagnosis is commonly delayed. This patient was seen in General Practice as well as in Accident and Emergency, where diagnoses of acute angle closure glaucoma as well as iritis were rightfully considered. Her symptoms persisted for 11 days before ophthalmic opinion was sought. Thorough assessment of a painful red eye as well as knowledge of these red-flag signs may allow early treatment and a better outcome for patients. The Royal College of Ophthalmologists has published guidance on how to assess and manage visual loss in people with learning difficulties, including recognising ‘symptoms’ such as hesitancy on steps, eye rubbing and loss of interest in activities.

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Section: Discussionmentioning

confidence: 91%

Bilateral posterior scleritis due to giant cell arteritis

2022

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“…Regarding GCA, acute sensorineural hearing loss rarely occurs in patients with GCA (27). Common ocular involvements in GCA are amaurosis and diplopia (28), and there have been few reports of patients with GCA who developed scleritis (29)(30)(31). Since CS is defined as variable vessel vasculitis (VVV) by the 2012 revised International Chapel Hill Consensus Conference (CHCC) Nomenclature of Vasculitides (32), we considered the present case to be one of CS mimicking GCA.…”

Section: Discussionmentioning

confidence: 99%

Atypical Cogan's Syndrome Mimicking Giant Cell Arteritis Successfully Treated with Early Administration of Tocilizumab

et al. 2022

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A 49-year-old Japanese man with a 2-month history of a fever, headache, and bilateral conjunctival hyperemia was admitted. His condition fulfilled the giant cell arteritis classification criteria (new headache, temporal artery tenderness, elevated ESR) and atypical Cogan's syndrome (CS) with scleritis and sensorineural hearing loss (SNHL). The interleukin (IL)-6 serum level was extremely high. Two weeks after his insufficient response of SNHL and scleritis to oral prednisolone, we administered tocilizumab (TCZ); rapid improvements in scleritis and SNHL occurred. Early IL-6 target therapy can help prevent irreversible CS-induced sensory organ damage.

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“…Though the most common cause of bilateral posterior scleritis is idiopathic, there are reports that it can occur in association with tuberculosis and giant cell arteritis [ 5 – 7 ]. Bilateral occurrence of posterior scleritis varies in each report; however, an incidence of 15.78% was reported in a study that analyzed 18 patients with the condition [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Bilateral posterior scleritis after sequential bilateral cataract surgery: a case report

et al. 2022

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Background Posterior scleritis is a rare, inflammatory ophthalmic disease, leading to severe visual impairment if untreated. Posterior scleritis occurring after surgery, unrelated to systemic inflammatory diseases, is even rarer. This report discusses a case of bilateral posterior scleritis, after cataract surgery in both the eyes, treated with high-dose steroids. Case presentation A 55-year-old man, who had undergone bilateral sequential cataract surgery one week before, presented with sudden loss of vision and ocular pain in both eyes. The patient had no systemic diseases or neurological symptoms. Serous retinal detachment of the macula with optic disc swelling was observed on fundus examination in both the eyes, and bilateral thickening of choroid and sclera was seen in ultrasonography. Under diagnosis of bilateral posterior scleritis due to the increased signal of sclera in both the eyes on magnetic resonance imaging, high-dose steroid therapy was performed. After treatment, improvement in visual acuity and retinal detachment were observed, and thereafter, it has been maintained without relapse. Conclusions With high-dose steroid therapy, we successfully treated a rare case of bilateral posterior scleritis following cataract surgery in both eyes. To our knowledge, this is the first report on posterior scleritis occurring after surgery, unrelated to systemic inflammatory diseases.

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Bilateral Posterior Scleritis Associated with Giant Cell Arteritis: A Case Report

Cited by 12 publications

References 9 publications

Bilateral posterior scleritis due to giant cell arteritis

Bilateral posterior scleritis due to giant cell arteritis

Atypical Cogan's Syndrome Mimicking Giant Cell Arteritis Successfully Treated with Early Administration of Tocilizumab

Bilateral posterior scleritis after sequential bilateral cataract surgery: a case report

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