• Choroidal thickness
• EDI-OCT
• clinical chracteristics
• ocular inflammatory disease posterior scleritis

• Humans
• Female
• Scleritis/diagnosis
• Scleritis/drug therapy
• Scleritis/epidemiology
• Male
• Retrospective Studies
• Middle Aged
• Adult
• Visual Acuity/physiology
• Tertiary Care Centers/statistics & numerical data
• Cross-Sectional Studies
• Tomography, Optical Coherence
• Aged
• Young Adult
• Microscopy, Acoustic
• Sclera/pathology
• Eye Pain/diagnosis
• Glucocorticoids/therapeutic use
• Follow-Up Studies
• Retinal Detachment/diagnosis
• Retinal Detachment/epidemiology
• Retinal Detachment/physiopathology
• Retinal Detachment/etiology

• Scleritis
• big data
• diffuse and nodular
• electronic medical records
• eyeSmart

• Corticosteroid
• immunosuppressives
• rheumatoid arthritis
• scleritis
• tuberculosis

• Corticosteroid
• Scleritis
• granulomatosis polyangitis
• necrotizing scleritis
• rheumatoid arthritis

To provide a comprehensive overview of choroidal involvement in non-infectious posterior scleritis; including different imaging modalities and their clinical usefulness.

Narrative review.

Posterior scleritis is an uncommon yet potentially sight-threatening inflammation of the sclera. During the disease process, inflammation can spread to the adjacent choroid, causing different manifestations of choroidal involvement: (1) increased choroidal thickness, (2) choroidal vasculitis, (3) presentation as a choroidal or subretinal mass in nodular posterior scleritis, and (4) choroidal folds, choroidal effusion and exudative retinal detachment.

Clinical characteristics and multimodal imaging can aid in diagnosing and monitoring disease progression and response to treatment in non-infectious posterior scleritis with choroidal involvement.

• Choroid
• Choroidal folds
• Choroidal involvement
• Choroidal mass
• Choroidal thickness
• Choroidal vasculitis
• Exudative retinal detachment
• Posterior scleritis

• Clinical features
• Exudative retinal detachment
• Optical coherence tomography
• Posterior scleritis
• Vogt–Koyanagi–Harada disease

To report the clinical profile of a series of anterior nodular scleritis in Indian population.

We conducted a retrospective review of medical records of 140 eyes of 123 consecutive patients with nodular scleritis who presented to a tertiary eye care institute between 2007 and 2018.

The mean age at presentation was 46.8 ± 13.1 years and 70.7% of the patients were female. Bilateral involvement was observed in 14% patients. The most common presenting symptom was redness (92.6%) and ocular pain (69.1%). Twenty-seven patients (22%) had some systemic association and rheumatoid arthritis (5%) was the most common autoimmune disease. Presumed ocular tuberculosis was diagnosed in 13% patients. Methotrexate was the most common immunosuppressive used in these patients and an additional immunosuppressive was required in 6.5% patients. Recurrence of inflammation was observed in 74.8% patients. Deterioration of vision noted in 2.8% eyes.

Tuberculosis remains an important cause of nodular scleritis in India. Recurrence of scleritis is common in nodular scleritis and cases with non infectious nodular scleritis often require treatment with immune suppressives.

• Anterior nodular scleritis
• cyclophosphamide
• methotrexate
• scleritis
• tuberculosis

• Adrenal Cortex Hormones/therapeutic use
• Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
• Corneal Ulcer
• Humans
• Sclera
• Scleritis/diagnosis
• Scleritis/drug therapy

• Chronic Disease
• Dry Eye Syndromes/complications
• Eye Pain/etiology
• Eye Pain/physiopathology
• Headache
• Humans
• Recurrence

Posterior scleritis is a rare inflammatory ocular disease, characterized by severe and painful inflammation of the sclera. It is often misdiagnosed or underdiagnosed, due to its general and varying clinical presentation profile, which primarily involves pain and visual impairment but which can include eyelid edema, choroidal folds, serous retinal detachment, disc edema, hard exudates in fovea and subretinal mass. We report here a case of posterior scleritis, with symptoms of eye pain and red eye, initially misdiagnosed as acute conjunctivitis.

A 56-year-old man presented to a local hospital with complaint of pain and redness in the right eye. The initial diagnosis was acute conjunctivitis and he was given antibiotic eyedrops. Upon week-long continuance of the symptoms despite treatment, he presented to our hospital. Initial examination revealed a shallow anterior chamber in the right eye and vision reduction to 0.6. Further testing by optical coherence tomography, ultrasound biomicroscopy, and fundus photography indicated diagnosis of posterior scleritis. The patient was given methylprednisolone (oral) on a tapered reduction schedule (starting with 70 mg/d). According to the peaks and troughs of symptoms, compound betamethasone injection was administered into the bulb, culminating in discontinuation of the oral corticosteroid. Subsequent optical coherence tomography showed the subretinal fluid near the optic disc to be completely absorbed after treatment.

Posterior scleritis should be among the differential diagnosis of eye pain and redness, and diagnosis requires further ophthalmic accessory examination, such as by optical coherence tomography.

• Posterior scleritis
• Eye pain
• Sclera
• Differential diagnosis
• Optical coherence tomography
• Case report

Chorioretinal folds (CRFs) are undulations of the choroid and overlying Bruch’s membrane, retinal pigment epithelium and neurosensory retina. CRFs represent a clinical sign that is mandatory to investigate assuming their association with several ocular and extra-ocular disorders. Recent advances in retinal imaging have improved the characterization of CRFs. More importantly, retinal imaging may be useful to detect ocular complications secondary to chronic CRFs, including the development of choroidal neovascularization.

• chorioretinal folds
• choroid
• maculopathy
• retina

• macula
• ophthalmology

This study was aimed at assessing the long-term ocular control of adalimumab (ADA) in a large real-world population with noninfectious primary or secondary uveitis, focusing on the steroid-sparing effect and on disease-modifying antirheumatic drug (DMARD) cotreatment.

In this retrospective, multicenter study, the efficacy of ADA was evaluated in terms of ocular control, changes in best-corrected visual acuity (BCVA), corticosteroid-sparing effect, and drug retention rate, overall and stratified according to DMARD cotreatment.

106 patients were included. 88.7% had an associated systemic disease. After 6 and 12 months, proportions of patients with effective ocular control were 83.7% and 83.3%, respectively. At last the follow-up, 94.6% of patients had satisfactory ocular control. No difference in terms of ocular control at all time points emerged among patients starting ADA for ocular vs. systemic involvements. Patients with poor baseline BCVA remained stable or improved, while those with good BCVA hardly worsened. At 6 and 12 months, the median dose of prednisone significantly reduced to 5 mg/day (0-5) and 2.5 mg/day (0-5) (p < 0.001). Over a median follow-up of 36 months, 38 subjects discontinued ADA treatment. Mild to moderate side effects were reported in 7 patients (6.6%). ADA ocular control, corticosteroid-sparing effect, and drug retention rate were not influenced by the concomitant use of DMARDs.

The long-term ocular control of ADA in noninfectious primary or secondary uveitis is confirmed, also for BCVA preservation. Concomitant use of DMARDs does not provide additional benefits to ADA alone in terms of ocular control, steroid spare, and drug retention rate.