Posterior scleritis in children.
Posterior scleritis was diagnosed in four adolescent boys. These patients represented a distinct subgroup of patients with posterior scleritis that differed from the adult variant by gender, lack of systemic disease, and absence of the associated ocular findings often seen in the adult variant of the disorder. The four patients had diminished visual acuity, ocular pain, and exudative retinal detachments at initial examination. Fluorescein angiography demonstrated multiple pinpoint leaks at the level of the retinal pigment epithelium in three patients with late-phase patchy staining of a mass-like lesion in one patient. B-scan ultrasonography demonstrated choroidal and scleral thickening with increased acoustic density of the choroid in all patients. Systemic evaluation of these patients disclosed no underlying disease. Clinical signs and symptoms resolved in three of the patients after treatment with low-dose, orally administered corticosteroid or noncorticosteroid anti-inflammatory medication. High systemic doses of corticosteroid in combination with noncorticosteroid anti-inflammatory medication and local corticosteroid therapy was required to induce remission in one patient. All patients recovered good visual acuity.
Wald
K J
KJ
LuEsther Mertz Retinal Research Laboratory, Manhattan Eye, Ear and Throat Hospital, New York, New York.
Spaide
R
R
Patalano
V J
VJ
Sugin
S
S
Yannuzzi
L A
LA
D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002648:Child; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D012163:Retinal Detachment / Q000000981:diagnostic imaging; D012164:Retinal Diseases / Q000175:diagnosis / Q000188:drug therapy; D015423:Scleritis / Q000175:diagnosis* / Q000188:drug therapy; D014463:Ultrasonography; D014792:Visual Acuity
D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids