Posterior scleritis: A clinical and histological survey

Abstract

SummaryThe clinical course of 47 patients with posterior scleritis is reviewed. Though clinical presenta tion varied widely, 73% of the patients presented with a visual acuity of 6/18 or less. Because the posterior scleritis was not always associated with pain or with anterior scleritis, the diag nosis was often not considered when the patient was first seen. The most common findings in the fundus were disc sweUing, retinal detachment, and macular oedema and the most useful in vestigation was B scan ultrasound. No common aetiology was found, although 60% had a sys temic disorder which was accompanied by a vasculitis. Those who were diagnosed and treated with the minimum delay had the most satisfactory visual outcome. However, there appears to be a group of patients with no underlying systemic disease who fail to respond to intensive therapy, and lose vision. A new sub-group of West Indians with the disease is described. The histopathology of 7 cases confirmed the presence of scleral vasculitis of the vessels in and around the sclera in all the specimens. Other significant findings include inflammatory swelling and focal loss of pigment epithelium together with choroidal vascular closure. This could ac count for the fluorescein angiographic findings.

Angle-closure glaucoma in a patient with systemic lupus erythematosus

“…In addition the choroideal and arterial perfusion normalized. In the literature, however, perfusion delay is not described in patients with a posterior scleritis [1,2,3,4,12,15], nor has a central retinal vein occlusion been described in these patients.…”

“…It may be associated with anterior scleritis, and may spread to involve the eye muscles and other orbital tissues, or to involve the choroid and retina [3]. Scleritis is almost always a local manifestation of a systemic disorder and the cells that cause the inflammation and destruction of tissue are almost certainly produced elsewhere than in the eye [10], Systemic lupus erythematosus [SLE] is the prototype of circulating immune complex diseases.…”

Esclerite posterior: características clínicas, associação sistêmica, tratamento e evolução de 23 pacientes

“…Interessantemente, em uma pequena série de pacientes (47) analisados em um artigo, houve preponderância de esclerite posterior no sexo masculino e em jovens (média de 19 anos) (13) . Segundo alguns autores, pacientes com mais de 50 anos de idade e esclerite apresentam maior risco de associação com doença sistêmica e perda visual (14)(15)(16) .…”

Long-term Follow-up of Giant Nodular Posterior Scleritis Simulating Choroidal Melanoma

“…The most common signs were serous retinal detachment (21%), optic nerve swelling (18%), and circumscribed fundus mass (13%). 8,9 It is noteworthy that our patient had no symptoms or associated collagen vascular disease. The only finding was nonpigmented fundus mass with minimal subretinal fluid.…”