Wald K J, Spaide R, Patalano V J, Sugin S, Yannuzzi L A
LuEsther Mertz Retinal Research Laboratory, Manhattan Eye, Ear and Throat Hospital, New York, New York.
Am J Ophthalmol. 1992 Mar 15;113(3):281-6. doi: 10.1016/s0002-9394(14)71579-x.
Posterior scleritis was diagnosed in four adolescent boys. These patients represented a distinct subgroup of patients with posterior scleritis that differed from the adult variant by gender, lack of systemic disease, and absence of the associated ocular findings often seen in the adult variant of the disorder. The four patients had diminished visual acuity, ocular pain, and exudative retinal detachments at initial examination. Fluorescein angiography demonstrated multiple pinpoint leaks at the level of the retinal pigment epithelium in three patients with late-phase patchy staining of a mass-like lesion in one patient. B-scan ultrasonography demonstrated choroidal and scleral thickening with increased acoustic density of the choroid in all patients. Systemic evaluation of these patients disclosed no underlying disease. Clinical signs and symptoms resolved in three of the patients after treatment with low-dose, orally administered corticosteroid or noncorticosteroid anti-inflammatory medication. High systemic doses of corticosteroid in combination with noncorticosteroid anti-inflammatory medication and local corticosteroid therapy was required to induce remission in one patient. All patients recovered good visual acuity.
四名青少年男性被诊断为后巩膜炎。这些患者代表了后巩膜炎患者中的一个独特亚组，在性别、无全身性疾病以及缺乏该疾病成人型中常见的相关眼部表现方面与成人型不同。这四名患者在初次检查时视力下降、眼痛且伴有渗出性视网膜脱离。荧光素血管造影显示，三名患者在视网膜色素上皮水平有多个点状渗漏，一名患者在晚期有类似肿块病变的斑片状染色。B超检查显示所有患者脉络膜和巩膜增厚，脉络膜声学密度增加。对这些患者进行的全身评估未发现潜在疾病。三名患者在接受低剂量口服皮质类固醇或非皮质类固醇抗炎药物治疗后临床体征和症状消失。一名患者需要高剂量全身皮质类固醇联合非皮质类固醇抗炎药物及局部皮质类固醇治疗才能诱导病情缓解。所有患者视力均恢复良好。
