Anterior and Posterior Scleritis

A case of anterior and posterior scleritis secondary to idiopathic orbital inflammation, also known as orbital pseudotumor. Various imaging modalities are included to demonstrate optic disc edema, macular edema, and fluid in tenon's capsule which may be seen in posterior scleritis. Figure 1 : External photograph of anterior scleritis demonstrating injection of scleral and episcleral vessels Figure 2 : Fundus photo of posterior pole demonstrating optic disc and macular edema Figure 3 : B-scan ultrasound image demonstrating thickining of the posterior sclera and choroid Figure 4 : B-scan ultrasound image demonstrating fluid in tenon's capsule Figure 5 : Late phase image from fluorescein angiogram demonstrating leakage of dye at the optic disc and macule Figure 6 : OCT scan demonstrating cystoid macular edema Figure 7 : Post-contrast T1-weighted axial MRI demonstrating diffuse enhancement of the fat, perineural sheath, and extraocular muscles in the right orbit. The left orbit is normal. Figure 8 : Post-contrast T1-weighted coronal MRI demonstrating diffuse enhancement of the fat, perineural sheath, and extraocular muscles in the right orbit. The left orbit is normal. Figure 9 : orbital fat biopsy demonstrates mild chronic non-specific inflammation. (Image courtesy of Dr. Hans Grossniklaus, LF Montgomery Pathology Lab, Emory University)