Título

POSTERIOR SCLERITIS SIMULATING CHOROID TUMOR: CASE REPORT

Introdução / Purpose

To report a case and discuss the topic.

Material e Método / Methods

METHODS: Male patient, CO, 57, attends our service with a diagnosis of choroidal tumor and a proposal of enucleation of the right eye. His main complaint is intense eye pain in the right eye with progressive worsening of visual acuity. The visual acuity during the consultation is 0.3 and 1.0 in right and left eye respectively. Anterior biomicroscopy showed 3+/4 conjunctival hyperemia and congestion of superficial and deep episcleral vessels. Fundus of right eye showed optic disk edema 3+/4, serous detachment of nasal retina with druseiform lesions. B ultrasound showed serous detachment, sclera thickening and T signal. The OCT pointed to serous detachment and optic disc edema. The left eye showed no changes. The diagnosis of choroidal tumor was discarted and posterior scleritis was chosen. We initiated treatment with oral corticosteroids associated with anti-inflammatory and topical corticosteroids. Serologies have been negative and the patient is waiting for consultation with a rheumatologist.

Resultados / Results

The patient progressed with an important improvement in pain and visual acuity progressed to 0.8.

Discussão e Conclusões / Discussion

DISCUSSION: Posterior scleritis is an inflammatory disease of sclera considered rare due to the difficulty of correct diagnosis. It has as main clinical manifestation of intense ocular pain, followed by alterations in visual acuity. There may be fundoscopic alterations such as serous detchment, uveal effusion, optic disk edema and subretinal infiltrates. Ultrasound B can be very useful not only for the diagnosis but also for the classification of the disease. Some cases may raise questions and simulate metastases or tumors such as melanoma. The patient reported an erroneous diagnosis of choroidal tumor as well as an indication of enucleation, but with the correct diagnosis and treatment it evolved with almost total improvement of the condition. For this reason the correct and early diagnosis is essential to prevent further dam

Palavras Chave

tumor, posterior scleritis

Area

CLINICAL RETINA