Wang Jia-Kang, Lai Pei-Ching, Yang Chang-Hao
Department of Ophthalmology, Far Eastern Memorial Hospital, Pan-Chiao, Taipei County, Taiwan.
Kaohsiung J Med Sci. 2003 Oct;19(10):522-5. doi: 10.1016/S1607-551X(09)70501-7.
We report a case of an unusual clinical presentation of posterior scleritis. A 40-year-old woman suffered from sudden blurred vision in her left eye for 1 day. She had no systemic or autoimmune diseases. Fundus examination revealed a subretinal mass (10.5 x 6 mm in basal diameter) in the nasal-superior quadrant extending from the optic disc to the periphery. Overlying retinal striae were obvious. Optic disc hyperemia and mild edema were noted. Fluorescein angiography did not show dye leakage or tumor-feeding vessels. Ultrasonography showed high internal reflectivity of the subretinal mass and thickened sclera with T-sign. Under the impression of posterior scleritis, corticosteroids and nonsteroidal anti-inflammatory drugs were given orally and topically. After 4 weeks, the subretinal mass disappeared without any sequelae. The patient recovered full vision. This case suggests that posterior scleritis is among the differential diagnoses for a fundus mass. There has been no other similar report in Taiwan.
我们报告一例后巩膜炎的不寻常临床表现。一名40岁女性左眼突然视力模糊1天。她没有全身性或自身免疫性疾病。眼底检查发现鼻上象限有一个视网膜下肿块(基底直径10.5×6mm),从视盘延伸至周边。上方视网膜条纹明显。可见视盘充血和轻度水肿。荧光素血管造影未显示染料渗漏或肿瘤供血血管。超声检查显示视网膜下肿块内部反射率高,巩膜增厚呈T征。在诊断为后巩膜炎后,给予口服和局部使用皮质类固醇及非甾体抗炎药。4周后,视网膜下肿块消失,无任何后遗症。患者视力完全恢复。该病例提示后巩膜炎是眼底肿块鉴别诊断的疾病之一。台湾地区尚无其他类似报告。