Posterior scleritis. A cause of diagnostic confusion.
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.
D000328:Adult; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005134:Eye Neoplasms / Q000175:diagnosis; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007249:Inflammation / Q000175:diagnosis; D008875:Middle Aged; D012590:Sclera