Posterior nodular scleritis : case reports

Author: Takwa SAMMOUDA (Tunisia)

Co-authors: Mouna Rekik, Omar Ayedi, Ramzi Souissi, Sofiene Affes, Salma Gargouri, Amira Trigui

Purpose

to report two cases of posterior nodular scleritis

Setting/Venue

Department of ophthalmology , Habib Bourguiba University Hospital, University of Sfax , Tunisia

Methods

two case reports with multimodal imaging

Results

Case 1: A 21-year-old female presented with painful decreased vision in the left eye for three weeks. Fundus examination revealed a whitish lesion in the posterior pole of the left eye. Fluorescein angiography showed hypofluorescents dots. Swept Source Optical coherence tomography (SS-OCT) revealed elevated choroid associated with subretinal fluid. B-scan ultrasonography showed a hyperreflective nodular lesion with retrobulbar hyporeflectivity (T sign). The lesion was hyperintense on MRI T1 sections. Case 2: a 56-year-old female with a past history of rheumatoid arthritis presented with a painful blurred vision left eye. Fundus examination showed a whitish mass in the posterior pole of the left eye with pinpoint hyperfluorescence on fluorescein angiography. SS-OCT revealed a thickened choroid with subretinal fluid. In both cases, clinical features and multimodal imaging were consistent with the diagnosis of posterior nodular scleritis. Both cases were treated with systemic non-steroidal anti-inflammatory drugs. A complete functional and anatomical recovery was noted in all cases.

Conlusions

Posterior nodular scleritis is an uncommon form of scleritis. It is often misdiagnosed as amelanotic melanoma. The distinction between these two affections is capital as the treatment, the workup, and the prognosis are different. Clinical features and multimodal imaging can help to identify the two of them.

Financial Disclosure

No financial disclosure