Background: Posterior scleritis is known to exhibit various changes in the ocular fundus, but retinochoroidal atrophy is a rare complication.
Case: A 54-year-old man presented with the complaint of blurred vision in the right eye. The patient had visited our clinic twice before, 22 and 11 years earlier. Although his funduscopic findings had demonstrated choroidal detachment in both eyes, the cause could not be determined at that time.
Findings: His visual acuity was 20/200, OD and 20/100, OS. Funduscopic examination showed annual choroidal detachments and geographic retinochoroidal atrophy in the posterior pole OU, and serous retinal detachment OD. B-scan ultrasonograpy revealed diffuse thickening and flattening of the posterior coats of the eye, and orbital enhanced computed tomography revealed thickening and enhancement of the posterior sclera. A diagnosis of posterior scleritis was made. Prednisolone 80 mg/ day was initiated and gradually tapered. Nine months later choroidal and serous retinal detachment were resolved.
Conclusion: We encountered a rare case of posterior scleritis with associated extensive retinochoroidal atrophy. We speculated that the cause was inflammation of the retina and choroid, and accumulation of subretinal fluid for a long period.