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Posterior scleritis in patients with systemic lupus erythematosus
Robert W Wong1, Annie Chan, Robert N Johnson
1From the *Pacific Vision Foundation, California Pacific Medical Center, San Francisco, California; and †Department of Ophthalmology, Stanford University School of Medicine, Stanford, California.
Purpose:
To describe three cases of posterior scleritis associated with systemic lupus erythematosus.
Methods:
Retrospective chart review including ophthalmic examination, fundus photography, optical coherence tomography, angiography, ultrasonography, and/or magnetic resonance imaging.
Results:
Three patients presented with blurred vision, red eye, and/or eye pain in one or both eyes. The diagnosis of posterior scleritis was confirmed in each patient using B-scan ultrasonography. One patient presented with giant nodular scleritis. In two patients, posterior scleritis was the presenting sign of systemic lupus erythematosus. Two patients received systemic corticosteroids together with noncorticosteroid immunosuppressive medications. One patient received topical and periocular injections of corticosteroids. All three patients showed prompt resolution of their posterior scleritis in response to treatment.
Conclusion:
While uncommon, posterior scleritis may occur in patients with systemic lupus erythematosus and, in some instances, may be the presenting sign of the disease. Prompt diagnosis and treatment was associated with good visual outcomes in our patients.
