Ocular immunology and inflammation · 2026
Misdiagnosed Cases of Posterior Scleritis: A Case Series and Review of Literature.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Kene Rakshita, Manna Giriraj, Biswas Jyotirmay, McCluskey Peter, Dutta Majumder Parthopratim
Аннотация
PURPOSE: To report a case series of posterior scleritis referred with an initial misdiagnosis to a tertiary eye care center and to review the literature on misdiagnosed cases of posterior scleritis.
METHODS: Retrospective chart review of patients diagnosed with posterior scleritis, along with a systematic review of published reports on misdiagnosed cases.
RESULTS: Between January 2013 and June 2023, 48 cases of posterior scleritis were evaluated, of which 27 patients (30 eyes; 56.2%) had been initially misdiagnosed elsewhere. The mean age was 44.6 ± 17.5 years (range, 11-73 years), with a female predominance (66.6%). Common initial misdiagnoses included choroidal or retinochoroidal mass lesions and optic neuritis (18.5% each), followed by orbital cellulitis (14.8%), Vogt-Koyanagi-Harada disease and posterior uveitis (11.1% each). Rare misdiagnoses included conjunctivitis, sarcoid panuveitis, anterior uveitis, and hemicranial headache. Ocular pain (70.3%), reduced vision (74.1%), and redness (44.4%) were common presenting features, while 25.9% had no visual complaints. Anterior uveitis was noted in 22.2% and vitritis in 14.8%. Fundus findings included subretinal fluid (56.6%), optic disc edema (36.6%), choroidal folds (26.6%), and mass-like lesions (16.6%). B-scan ultrasonography was performed in only 33.3% of cases, with none demonstrating a T-sign. A literature review identified previously reported misdiagnosed cases, which were analyzed and tabulated with their clinical features and reasons for misdiagnosis.
CONCLUSION: Posterior scleritis is frequently overlooked due to its protean and heterogeneous clinical presentations, leading to misdiagnosis as other ocular or orbital conditions.
METHODS: Retrospective chart review of patients diagnosed with posterior scleritis, along with a systematic review of published reports on misdiagnosed cases.
RESULTS: Between January 2013 and June 2023, 48 cases of posterior scleritis were evaluated, of which 27 patients (30 eyes; 56.2%) had been initially misdiagnosed elsewhere. The mean age was 44.6 ± 17.5 years (range, 11-73 years), with a female predominance (66.6%). Common initial misdiagnoses included choroidal or retinochoroidal mass lesions and optic neuritis (18.5% each), followed by orbital cellulitis (14.8%), Vogt-Koyanagi-Harada disease and posterior uveitis (11.1% each). Rare misdiagnoses included conjunctivitis, sarcoid panuveitis, anterior uveitis, and hemicranial headache. Ocular pain (70.3%), reduced vision (74.1%), and redness (44.4%) were common presenting features, while 25.9% had no visual complaints. Anterior uveitis was noted in 22.2% and vitritis in 14.8%. Fundus findings included subretinal fluid (56.6%), optic disc edema (36.6%), choroidal folds (26.6%), and mass-like lesions (16.6%). B-scan ultrasonography was performed in only 33.3% of cases, with none demonstrating a T-sign. A literature review identified previously reported misdiagnosed cases, which were analyzed and tabulated with their clinical features and reasons for misdiagnosis.
CONCLUSION: Posterior scleritis is frequently overlooked due to its protean and heterogeneous clinical presentations, leading to misdiagnosis as other ocular or orbital conditions.