Posterior scleritis in Wegener disease

Background: Wegener's granulomatosis is a focal necrotizing granulomatous vasculitis of unknown etiology. It manifests initially as localized inflammation, usually of the lungs, and preceeds to the state of generalisation which can be life-threatening due to renal failure. Ocular and orbital involvement occurs in 28-58% of patients with Wegener's granulomatosis. More often, the anterior segments of the eye are involved whereas inflammation of the posterior segments is quite uncommon.

Methods: We report a case of posterior scleritis as the initial manifestation of Wegener's granulomatosis in a 65-year-old woman.

Results: Posterior scleritis responded favourably to therapy with systemic steroids and cyclophosphamide.

Conclusions: Wegener's granulomatosis can have a poor prognosis if not diagnosed and treated in time. Knowledge of posterior scleritis as a possible presenting symptom may therefore facilitate early diagnosis and treatment and prevent progression of the disease.