FP350 : Looking behind the facade – IgG4-Related Disease manifesting as Posterior scleritis

Dr.DUBEY NIDHI, D17143

We report a rare case of IgG4-related orbital disease (IgG4-RD) presenting as posterior scleritis. A 37 -year-old male patient presented with right eye pain and redness for 3 months. On Ocular examination there was proptosis with deep episcleral conjestion. Retinal examination showed choroidal folds with exudative retinal detachment and on B- Scan T sign was noted. Investigations for infective and connective tissue disease were normal. However, CT scan orbit showed a retro orbital mass. An orbitotomy for excisional biopsy was performed. Histopathological characteristics revealed IgG4-RD. Long-term treatment with corticosteroids and a steroid-sparing agent (Azathioprine) led to significant improvement in clinical picture . This case highlights the significance of considering IgG4-RD in the differential diagnosis of Scleritis with a few case reports in the past.