Giant nodular posterior scleritis simulating choroidal melanoma.
A 45-year-old woman, complaining of sudden visual loss in the right eye (best-corrected visual acuity: 17/200), was suspected of having a malignant melanoma of the choroid. Fundus examination revealed a massive pale-colored subretinal mass temporal to the fovea, with adjoining choroidal folds and exudative retinal detachment. Ultrasonography was suggestive of posterior scleritis. Systemic evaluation was unremarkable. The patient was treated with high-dose systemic corticosteroids. The mass lesion resolved completely, with visual recovery to 20/20. Posterior scleritis should be suspected when evaluating subretinal mass-lesions, even when large and without overt inflammation. Early treatment may improve the visual prognosis and avoid misdirected management, including enucleation.
Shukla
Dhananjay
D
Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Anna Nagar, Madurai, Tamil Nadu, India. daksh@aravind.org
Kim
Ramasamy
R
D002830:Choroid Neoplasms / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008545:Melanoma / Q000175:diagnosis*; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D015423:Scleritis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D014463:Ultrasonography
D005938:Glucocorticoids; D008775:Methylprednisolone