Presentation
Known patient of systemic lupus presented with acute onset bilateral orbital pain, swelling and diminution of vision. Fundus examination revealed serous retinal detachment.
Patient Data
Focal posterior scleral thickening and enhancement, associated with periscleral edema and preseptal edema.
Posterior scleral thickening and enhancement (Red arrows)
Periscleral edema (Blue arrow)
Preseptal edema (Yellow arrows)
Case Discussion
Diagnosis was confirmed by Ultrasonography and the patient improved after systemic steroid treatment.
Scleritis is a rare, underdiagnosed vision-threatening condition.
The etiology of scleritis is mainly inflammatory noninfectious, either idiopathic or in the context of systemic disease (e.g. rheumatoid, systemic lupus, granulomatosis with polyangiitis or Behçet).
Ultrasonography remains the criterion standard in diagnostic imaging of this condition.
CT and MRI also play an important role in diagnosis, radiological features include:
- scleral thickening end enhancement
- periscleral edema
Treatment: using nonsteroidal anti-inflammatory drugs or steroids.
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