B-Scan Ultrasonography Findings in Unilateral Posterior Scleritis

Arash Maleki; Maria Ruggeri; Amanda Colombo; Soheila Asgari; Sydney Look-Why; Shimy Apoorva; C Stephen Foster

doi:10.4103/joco.joco_267_21

B-Scan Ultrasonography Findings in Unilateral Posterior Scleritis

J Curr Ophthalmol. 2022 Apr 16;34(1):93-99. doi: 10.4103/joco.joco_267_21. eCollection 2022 Jan-Mar.

Authors

Arash Maleki^{1

2}, Maria Ruggeri^{1

2}, Amanda Colombo^{1

2}, Soheila Asgari^{1

2}, Sydney Look-Why^{1

2}, Shimy Apoorva^{1

2}, C Stephen Foster^{1

2

3}

Affiliations

¹ Massachusetts Eye Research and Surgery Institution, Waltham, MA, USA.
² The Ocular Immunology and Uveitis Foundation, Waltham, MA, USA.
³ Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.

Abstract

Purpose: To evaluate the B-scan ultrasound findings in unilateral posterior scleritis.

Methods: This was a retrospective observational case series at a tertiary uveitis clinic. The study population included patients who had been diagnosed with milder forms of unilateral posterior scleritis since 2010 and had B-scan ultrasonography of that eye. The healthy eye of each patient was considered the control eye for that patient.

Results: The average age of patients was 50.2 ± 17.8 (range, 18-67). Posterior scleritis was idiopathic in 6 (66.7%) patients and associated with rheumatoid arthritis in two and HLA-B27 ankylosing spondylitis in one patient. The thickness of the thickest area in the diseased eye was 2.08 ± 0.49 (range, 1.35-3.2) and the control eye was 1.53 ± 0.38 (range, 1.03-2.3). The difference between the symptomatic and control eye was statistically significantly different (P = 0.02). 1.7 mm was the cut-off-point on the receiver operating characteristics curve with the highest combined sensitivity and specificity of 87.5% and 88.9%, respectively. Comparing the thickness of the thickest section of the symptomatic eye of one patient with the same section in the other eye of the same patient, there was a difference of 20% or more in sclero-choroidal complex.

Conclusions: In this study, the sclero-choroidal complex thickness higher than 1.7 mm has the highest combined sensitivity and specificity. Comparing the thickest section of the symptomatic eye of one patient with the same section in the other eye can be diagnostic.

Keywords: B-scan ultrasonography; Posterior scleritis; Scleral nodule; Sclero-choridal complex; T-sign; Ultrasound.