Posterior scleritis-induced optic neuropathy and exudative retinal detachment – A challenging diagnostic dilemma

Abstract

We report three cases of posterior scleritis (PS) to analyze the clinical profile and ultrasonographic and fluorescein angiography features of this rare disorder. Fundus findings included serous retinal detachment (RD), disc edema, disc hyperemia, corkscrewed retinal vessel, and retinal folds. Ultrasonography revealed a variable degree of thickening of the posterior eye wall (choroid and sclera). Fluorescein angiography revealed persistent dye leakage from the disc and early pinpoint areas of hyperfluorescence with pooling of dye in late frames of an angiogram. Optical coherence tomography showed serous macular detachment in all cases at the time of presentation. The purpose of this manuscript was to describe three cases of PS associated with optic neuropathy and exudative RD previously misdiagnosed with a range of conditions. This case study also demonstrates the importance of B-scan ultrasonography and fluorescein angiography for the appropriate diagnosis of PS and also the effectiveness of systemic corticosteroid therapy.

Keywords

• b-scan ultrasonography
• exudative retinal detachment
• fundus fluorescein angiography
• optic neuropathy
• posterior scleritis