A Case of Giant Nodular Posterior Scleritis

ABSTRACT

PURPOSE: The authors report a case of a giant subretinal nodular mass following surgical vitreous opacity removal. CASE SUMMARY: A 72-year-old man complained of visual loss and vitreous floaters in the left eye for 3 months (best corrected visual acuity 0.1). The fundus was not clearly visualized due to vitreous opacity. Vitrectomy, phacoemulsification, and posterior chamber intraocular lens implantation were performed in the left eye. After removing the vitreous opacity, fundus examination revealed a creamy yellowish-white subretinal nodular mass (4 disc in size) infero-temporal to the fovea with adjoining chorioretinal folds and exudative retinal detachment. Fluorescein angiography (FA) of the left eye showed hypofluorescence of the nodule surrounded by a well-demarcated hyperfluorescent margin. B-scan ultrasonography revealed a prominent dome-shaped large echogenic nodule bordered by hypoechoic signal at the sclerochoroidal level. Giant nodular posterior scleritis was suspected and the patient was treated with oral corticosteroids. The large nodular lesion resolved completely within 3 months after initiation of the treatment and the best corrected visual acuity improved to 0.5. CONCLUSIONS: The authors of the present case study recommend a thorough evaluation of large posterior segment nodular lesions in order to detect this under-recognized but eminently treatable condition.