Abstract：
An 84-year-old man presented with decreased right-eye visual acuity. Upon initial examination, the rightand left-eye visual acuities were 0.03 and 1.2, respectively; moreover, the right- and left-eye intraocular pressure was 12 mmHg and 13 mmHg, respectively. Examination revealed a shallow anterior chamber of the right eye, anterior chamber inflammation, vitreous opacity, and marked retinochoroidal detachment. Optical coherence tomography (OCT) revealed retinal detachment (RD) and choroidal folds; moreover, B-scan ultrasonography (B-scan) showed RD as well as thickened sclera with fluid in Tenon\'s space. Fluorescent fundus angiography revealed hyperfluorescence in the optic disc and vascular hyperpermeability in the right eye. The left eye lacked extra-ocular symptoms or abnormalities. The right ocular axis measured 23.4 mm with no apparent subretinal fluid migration due to positional changes. Accordingly, the patient was diagnosed with panuveitis associated with posterior scleritis and immediately started on 40 mg prednisolone, which improved his symptoms. However, at 3 post-treatment months, choroidal folds were observed and was restarted on 20 mg prednisolone. The choroidal folds subsequently disappeared, with a current visual acuity of 0.3 in the right eye and no recurrence. Our findings indicated the utility of accurate diagnosis of posterior scleritis by B-scan and prompt systemic steroid administration.
摘要：
一名84岁的男子表现出右眼视力下降。经过初步检查,右眼和左眼视力分别为0.03和1.2；此外，右眼和左眼眼压分别为12mmHg和13mmHg，分别。检查发现右眼前房浅,前房炎症,玻璃体混浊,和明显的视网膜脉络膜脱离.光学相干断层扫描（OCT）显示视网膜脱离（RD）和脉络膜褶皱；B超检查（B-scan）显示RD以及巩膜增厚，Tenon's间隙有液体。荧光眼底血管造影术显示视盘高度荧光，右眼血管通透性过高。左眼没有眼外症状或异常。右眼轴测量为23.4mm，由于位置变化，没有明显的视网膜下液迁移。因此，患者被诊断为与后巩膜炎相关的全葡萄膜炎，并立即开始使用40毫克泼尼松龙，改善了他的症状.然而,在治疗后3个月，观察到脉络膜皱褶，并在20mg泼尼松龙时重新开始。脉络膜褶皱随后消失了，右眼目前视力为0.3，无复发。我们的发现表明，通过B扫描和及时的全身类固醇给药可以准确诊断后巩膜炎。
