Pediatric posterior scleritis: a Case report.

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Presentation transcript:

Pediatric posterior scleritis: a Case report. Stephany Carrillo, Alberto Calvo, Carme Macià, Antonio Segura. Hospital Universitario Valle de Hebrón

Case Patient: 13 year old female Redness and painful left eye movements for one day. BCVA: RE: 20/20 / LE: 20/30 No movements limitations Slit lamp: RE: Normal / RE: Ciliary injection and tyndall +0.5. Fundoscopy: RE: Normal LE: Vitritis +1 and posterior serous retinal detachment

Fundoscopy:

B‑scan ultrasonography

Autofluorescence

posterior serous retinal detachment

Left Eye Fluorescein Angiography

Left eye Periphery Angiography

Approach Normal chest X‑ray Complete blood count, erythrocyte sedimentation rate, C‑reactive protein, Immuno-proteins; anti-transglutaminase, rheumatoid, anti‑nuclear, and Anti-neutrophil cytoplasmic antibodies (ANCAs) were normal. Serology for Bartonella henselae and quintana, Borrelia burgdorferi, Treponema pallidum, and Toxoplasma gondii were negative.

Posterior scleritis Inflammation of the sclera posterior to the equator Prevalence: six cases per 10,000 population (anterior scleritis 94% posterior scleritis 6%) Rare In the pediatric age group It is often idiopathic. It occurs both in males and females.

Treatment for idiopathic posterior scleritis Topical dexamethasone and cycloplegia 60 mg oral prednisolone per day.

Follow up Day 1 Day 6 Day 8

Follow up

Conclusion: Posterior scleritis is rare in pediatric age group. It should be considered in the differential diagnosis of acute pain, redness, and loss of vision. Autoimmune and infectious diseases must be ruled out, though often idiopathic. Prompt treatment with systemic steroids may lead to complete visual recovery.