Posterior scleritis. A cause of diagnostic confusion
W. E. Benson, J. A. Shields, W. Tasman and A. S. Crandall
The referring diagnoses in seven women with posterior scleritis included
intraocular neoplasm, retrobulbar tumor, choroiditis, and idiopathic
central serous choroidopathy. In all cases, a localized area of intense
posterior scleritis was responsible for the misdiagnosed ocular findings.
Features that helped to correctly identify posterior scleritis were as
follows: female sex; a history of anterior scleritis; a fundus mass the
same color as normal adjacent pigment epithelium; choroidal folds; serous
retinal detachment with cloudy fluid; early pinpoint leaking spots from
fluorescein angiography; and thickening of the posterior coats of the eye,
retrobulbar edema, and high internal reflectivity on ultrasonography.
Corticosteroids given for retrobulbar or systemic effect provided effective
treatment.
