Nodular posterior scleritis mimicking choroidal metastasis: a report of two cases

Rabih Hage, Albert Jean-Charles, Jérôme Guyomarch, Olivier Rahimian, Angélique Donnio, Harold Merle
Department of Ophthalmology, University Hospital of Fort-de-France, Martinique, French West Indies

Abstract: Posterior scleritis is a rare underdiagnosed condition that can potentially cause blindness. Its varied presentations lead to delayed or incorrect treatment. We present here the cases of two patients with nodular posterior scleritis mimicking a choroidal metastasis. Two female patients presented with a sudden unilateral visual loss associated with ocular pain. Fundus examination revealed temporomacular choroidal masses with exudative detachments that, due to angiographic presentation, were suggestive of choroidal metastasis. Systemic examinations were unremarkable. In the two cases, a local or general anti-inflammatory treatment led to the complete recovery of the lesions, which were, thus, considered nodular posterior scleritis. The diagnosis of nodular posterior scleritis has to be evoked in all patients presenting with a choroidal mass in fundus examination. It represents the principal curable differential diagnosis of malignant choroidal tumor.

Keywords: choroidal tumor, choroidal mass, visual loss, ocular pain, blindness, posterior scleritis