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Nodular Posterior Scleritis: Clinico-Sonographic Characteristics and Proposed Diagnostic Criteria

Agrawal, R; Lavric, A; Restori, M; Pavesio, C; Sagoo, MS; (2015) Nodular Posterior Scleritis: Clinico-Sonographic Characteristics and Proposed Diagnostic Criteria. Retina , 36 (2) pp. 392-401. 10.1097/IAE.0000000000000699. Green open access

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Abstract

Purpose: 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%). / Conclusion: 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.

Type: Article
Title: Nodular Posterior Scleritis: Clinico-Sonographic Characteristics and Proposed Diagnostic Criteria
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/IAE.0000000000000699
Publisher version: http://dx.doi.org/10.1097/IAE.0000000000000699
Language: English
Additional information: Copyright: © 2016 by Ophthalmic Communications Society, Inc.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology
URI: https://discovery.ucl.ac.uk/id/eprint/1470774
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