An unusual case of Behcet disease with posterior scleritis
Posterior scleritis is an ocular inflammatory disorder that is predominantly idiopathic, autoimmune, or rarely, infective. On the other hand, Behcet disease is a chronic autoimmune disease with unknown etiology, which causes inflammation in multiple organs including skin, mucous membranes, and nerves, resulting in functional and organic disorders. The most common clinical signs of ocular manifestations of Bechet disease are hypopyon, macular edema, and retinal vasculitis. In general, scleritis may complicate rheumatoid arthritis and ANCA-associated vasculitis, but the association of scleritis with Behcet disease is rare.

A 50-year-old man presented with left ocular pain and decreased vision. He was diagnosed with Behcet disease positive for HLA A-26 in 2006, and had been treated in our hospital with colchicine and topical corticosteroid for inflammatory attacks.

At presentation, his corrected visual acuity was 20/25 in the right eye and 20/200 in the left eye, and intraocular pressure was normal. The anterior chamber and vitreous body of the left eye showed 1+ inflammatory cells and fundus examination revealed redness of the optic disc in both eyes and focal choroidal folds in the left eye. Fluorescein angiography revealed leakage from the optic disc in both eyes and mild linear hypo-fluorescence at the posterior pole of the left eye. Optical coherence tomography showed a serous macular detachment in the right eye and choroidal folds in the left eye. Ultrasonography showed thickening of the posterior sclera.

Source: Medicine: August 2019

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