OSLI Retina

October 2019

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660 Ophthalmic Surgery, Lasers & Imaging Retina | Healio.com/OSLIRetina ■ I M A G E S I N O P H T H A L M O L O G Y ■ Posterior Scleritis Ryan A. Shields, MD; Ira H. Schachar, MD The patient is a 19-year-old female who presented with 3 weeks of right eye pain, eyelid swelling, blurry vision, and headache. Visual acuity was counting fingers at 1 foot. Intraocular pressure was normal, and there was diffuse scleral injection on anterior examination. She had a mild anterior chamber reaction with 15 cells/high-powered field and a mild vitreous inflammatory reaction. Fundus examination revealed diffuse choroidal thickening with multilobulated serous retinal detachments worse inferiorly (Figures 1 and 2). Fluorescein angiography demonstrated severe optic disc leakage. Ultrasonography demonstrated diffuse choroidal thickening, a serous retinal detachment, and a prominent "T-sign" (Figure 3). The patient was diagnosed with posterior scleritis and treated with 80 mg of oral prednisone. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:660.] Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California. Originally submitted February 2, 2019. Revision received February 6, 2019. Accepted for publication April 3, 2019. The authors report no relevant financial disclosures. Address correspondence to Ryan A. Shields, MD, Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, 2452 Watson Ct., Palo Alto, CA, 94303; email: ras3@stanford.edu. doi: 10.3928/23258160-20191009-11 Figure 1. Wide-angle Optos (Dunfermline, United Kingdom) fun- dus photo of the right eye demonstrating diffuse choroidal thick- ening, multilobulated serous retinal detachments (most notably superior and nasal), vascular congestion, and optic nerve edema. Figure 2. Wide-angle Optos (Dunfermline, United Kingdom) fun- dus photo of the right eye focused inferiorly revealing an additional inferior serous retinal detachment. Figure 3. Horizontal axial B-scan ultrasonog- raphy of the right eye demonstrating a clear vitreous cavity, shallow serous retinal detach- ment, prominent choroidal thickening, and fluid (hypoechogenicity) in the posterior sub-Tenon's space (positive "T-sign").

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