Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Middle East Afr J Ophthalmol. 2023 May 25;29(3):159-162. doi: 10.4103/meajo.meajo_180_22. eCollection 2022 Jul-Sep.
Anterior scleritis is rarely diagnosed with a peripheral amelanotic subretinal mass. We reported a rare case of a 31-year-old woman who was referred for suspected left eye choroidal melanoma. The patient had granulomatosis with polyangiitis with a history of treated left eye necrotizing anterior scleritis. Her left eye examination revealed 20/60 vision, superotemporal diffuse scleral injection, and thinning. Dilated fundus examination of the left eye showed a large peripheral amelanotic subretinal mass below the area of anterior scleritis, optic disc hyperemia, and subretinal fluid. The patient was successfully treated with intravenous methylprednisolone, rituximab infusions, and oral methotrexate. Two months after treatment, her vision improved to 20/20, with inactive anterior scleritis and a significant reduction in the subretinal mass with complete resolution of optic disc hyperemia and subretinal fluid. High index of suspicion of this atypical presentation of anterior scleritis is important to avoid aggressive modalities of treatment.
前部巩膜炎很少伴有周边无色素性视网膜下肿块被诊断出来。我们报告了一例罕见的 31 岁女性病例，她因疑似左眼脉络膜黑色素瘤而被转介。该患者患有肉芽肿性多血管炎，曾患有左眼坏死性前部巩膜炎。她的左眼检查显示视力 20/60，上方弥漫性巩膜注射和变薄。左眼散瞳眼底检查显示前部巩膜炎区域下方有一个大的周边无色素性视网膜下肿块，视盘充血和视网膜下积液。该患者成功接受了静脉注射甲基强的松龙、利妥昔单抗输注和口服甲氨蝶呤治疗。治疗两个月后，她的视力提高到 20/20，前部巩膜炎活动度降低，视网膜下肿块明显缩小，视盘充血和视网膜下积液完全消退。对这种不典型前部巩膜炎表现的高度怀疑对于避免激进的治疗方式很重要。
