Nodular Posterior Scleritis Masquerading as a Subretinal Mass.

Area of Science:

• Ophthalmology
• Rheumatology

Background:

• Posterior nodular scleritis is a rare, potentially vision-threatening ocular inflammatory condition.
• Early diagnosis and treatment are crucial for managing this condition.

Observation:

• A 50-year-old female presented with unilateral eye pain and visual loss.
• Fundoscopy revealed a subretinal mass, swollen optic disc, and retinal detachment.
• Elevated erythrocyte sedimentation rate was noted, with negative infective and autoimmune markers.

Findings:

• The patient was diagnosed with posterior nodular scleritis.
• Treatment with intravenous and oral corticosteroids resulted in complete resolution of the subretinal mass.
• Optic atrophy was observed as a sequela despite successful mass resolution.

Implications:

• This case highlights the importance of multimodal investigations for diagnosing posterior nodular scleritis.
• Aggressive treatment with corticosteroids can be effective but may lead to optic atrophy.
• Ophthalmologists should consider posterior nodular scleritis in cases of unexplained subretinal masses and visual disturbances.