title: NODULAR POSTERIOR SCLERITIS: Clinico-Sonographic Characteristics and Proposed Diagnostic Criteria.
abstract: OBJECTIVE
  To report the clinical and ultrasound features and outcomes of a series of nodular posterior scleritis.
  
  
  METHODS
  Retrospective medical record review of 11 consecutive patients with nodular posterior scleritis. Patient demographics, ocular and systemic findings, ultrasound features, and final anatomical and visual outcomes were recorded.
  
  
  RESULTS
  There were 9 females and 2 males (11 eyes) with mean age at presentation of 57 years (range, 30-84 years). Underlying systemic inflammatory disease was present in 73%. Symptoms included pain in 73% and blurred vision in 45%. A solitary amelanotic mass without the presence of lipofuscin was found in all cases. Associated ocular features included retinal pigment epithelial changes (67%), intraocular inflammation (55%), subretinal fluid (50%), macular edema (50%), and choroidal folds (30%). B-mode ultrasound showed a sclerochoroidal mass with high internal reflectivity (100%) of mean elevation of 4.1 mm. There was nodular thickening of the sclera (100%) and fluid in Tenon space or "T" sign (36%). A complete regression of the nodule after the treatment was observed only in 1 patient (11%) and partial regression in 4 patients (44%).
  
  
  CONCLUSIONS
  Nodular posterior scleritis should be considered in the differential diagnosis of a single amelanotic choroidal mass showing high internal reflectivity on ultrasound B-scan. It can produce intraocular inflammation in 50% of the cases and may be painless in 25%. It has a high association with a systemic underlying disease.
authors: *Biomedical Research Centre, Department of Medical Retina, Moorfields Eye Hospital, London, United Kingdom; †UCL Institute of Ophthalmology, London, United Kingdom; ‡National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore; §Ocular Oncology Service, St. Bartholomew's Hospital, London, United Kingdom; and ¶Eye Hospital, University Medical Centre, Ljubljana, Slovenia.
authors: Rupesh
authors: R
authors: Agrawal
authors: Alenka
authors: A
authors: Lavric
authors: Marie
authors: M
authors: Restori
authors: Carlos
authors: C
authors: Pavesio
authors: Mandeep S
authors: MS
authors: Sagoo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002830:Choroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D058447:Eye Pain / Q000175:diagnosis; D005260:Female; D005451:Fluorescein Angiography; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008269:Macular Edema / Q000175:diagnosis; D008297:Male; D018328:Melanoma, Amelanotic / Q000000981:diagnostic imaging* / Q000473:pathology; D008875:Middle Aged; D012189:Retrospective Studies; D015423:Scleritis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D058471:Subretinal Fluid; D041623:Tomography, Optical Coherence; D014463:Ultrasonography; D014786:Vision Disorders / Q000175:diagnosis; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids