Posterior scleritis in pediatric age group: A case report and review of literature

Shenoy, Radha; Suryawanshi, Milind; Isaac, Roshini; Philip, Santhosh K

doi:10.4103/0974-620x.176121

Cited by 13 publications

(12 citation statements)

References 10 publications

(78 reference statements)

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“…the fibrous outer layer of the eye) [1]. 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.…”

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

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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.

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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

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“…Posterior scleritis is a potentially blinding disease 1 2. The inflammatory process involves sclera posterior to the ora serrata.…”

Section: Discussionmentioning

confidence: 99%

“…It may be associated with concurrent anterior scleritis. It accounts for 2–12% of all scleritis cases 1 2. Posterior scleritis in the paediatric population is a rare entity.…”

Section: Discussionmentioning

confidence: 99%

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Posterior scleritis presenting as conjunctivitis in a child

Mallick

Pujahari

Maharana³

2016

BMJ Case Reports

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A 14-year-old male child presented with redness and decreased vision in the right eye for 7 days. He was being treated for viral conjunctivitis for right eye at a local hospital. His visual acuity was 6/24 OD and 6/9 OS. Slit-lamp examination revealed diffuse conjunctival congestion in the right eye. Dilated fundus examination revealed mild disc hyperaemia and retinal striae in both the eyes. A peripapillary serous detachment of macula in the right eye was seen on optical coherence tomography. B scan ultrasonography revealed increased scleral thickening and characteristic 'T' sign in both the eyes. Investigations revealed no other relevant systemic association. A diagnosis of bilateral posterior scleritis was made. The patient was started on topical steroids and oral non-steroidal anti-inflammatory drugs. Within 2 weeks of therapy the visual acuity improved to 6/6, the serous detachment resolved and retinal striae reduced in both the eyes.

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“…She has since been lost to follow-up.DiscussionPosterior scleritis in children is uncommon. 1,2 Review of the literature, including the largest case series to date, indicates that pediatric posterior scleritis has not been associated with any underlying systemic disorder [1][2][3]. In the past, typical laboratory investigations for posterior not included ASO titers, although there are case reports of anterior scleritis associated with rheumatic fever in a child and posterior scleritis associated with a poststreptococcal syndrome in an adult 4,5.…”

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confidence: 96%