[Posterior scleritis: six case reports].
OBJECTIVE
To study the clinical features, management guidelines, and the course of the disease in six patients with posterior scleritis.


METHODS
Six patients with posterior scleritis were enrolled in this retrospective study. All patients underwent a complete ophthalmic examination, fluorescein angiography, and B-scan ultrasonography. Systemic evaluation included physical examination and laboratory screening investigations. Medical management included systemic indomethacin (two cases), oral steroids (two cases), intravenous pulses of methylprednisolone followed by tapered oral steroids (two cases). One patient underwent immunosuppressive therapy (azathioprine) because of steroid dependence.


RESULTS
The main presenting symptoms were pain (six cases) and decreased vision (four cases). Chorioretinal changes included chorioretinal folds (six cases), retinal folds (five cases), optic disc edema (five cases), serous retinal detachment (two cases), and a subretinal mass (one case). Ultrasonography disclosed sclerochoroidal thickening in all cases and retrobulbar edema in three cases. Systemic evaluation was unremarkable in five cases and revealed Behçet's disease in one case. All patients showed a good response to medical treatment.


CONCLUSIONS
Posterior scleritis has protean manifestations and can be easily overlooked. This diagnosis must be considered in all inflammatory and painful ocular disorders with no obvious etiology. B-scan ultrasonography is the most useful diagnostic tool in such patients. The disease usually shows a good response to systemic anti-inflammatory therapy.
Service d'Ophtalmologie, Hôpital Universitaire Fattouma Bourguiba, 5019 Monastir, Tunisie. ahmed.ladjimi@rns.tn
A
A
Ladjimi
R
R
Messaoud
S
S
Attia
S
S
Jenzri
S
S
Zaouali
K
K
Chaouch
L
L
Bhouri
B
B
Jelliti
M
M
Khairallah
D000284:Administration, Oral; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007213:Indomethacin / Q000627:therapeutic use; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D012189:Retrospective Studies; D015423:Scleritis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D007166:Immunosuppressive Agents; D001379:Azathioprine; D008775:Methylprednisolone; D007213:Indomethacin