Abstract
Background
To assess multimodal imaging findings of focal scleral nodule (FSN) to evaluate its origin and natural course.
Methods
This was a retrospective observational case series and included 14 patients with FSN who underwent multimodal imaging. Clinical information was gathered from patients’ medical records. Primary outcome measures were standardized grading of imaging features.
Results
The mean follow-up duration was 68.8 ± 43.6 months (range, 6-139 months). Most lesions were solitary (92.6%), but one patient had two adjacent lesions (7.1%). Optical coherence tomography revealed that all lesions were confined to the sclera. Lesions showed mostly outer retinal abnormality, with external limiting membrane thinning or absence in 41.6% of lesions and ellipsoid layer absence in 84.6% of lesions. Most lesions showed an absence (69.2%) or thinning (23.1%) of the choroid above the lesion, and the mean choroidal thickness above the lesion for choroids with measurable thickness was 36 ± 75 μm (median, 0; range, 0–265 μm). Of 13 lesions with available follow-up data, only three lesions showed minimal growth over time.
Conclusions
This study demonstrates for the first time that bifocal lesions of FSN in the same eye are possible and reaffirms the relative stability of this entity.
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Change history
24 August 2022
A Correction to this paper has been published: https://doi.org/10.1038/s41433-022-02203-2
References
Hong PH, Jampol LM, Dodwell DG, Hrisomalos NF, Lyon AT. Unifocal helioid choroiditis. Arch Ophthalmol. 1997;115:1007–13.
Shields JA, Shields CL, Demirci H, Hanovar S. Solitary idiopathic choroiditis: the Richard B. Weaver lecture. Arch Ophthalmol. 2002;120:311–9.
Fung AT, Kaliki S, Shields CL, Mashayekhi A, Shields JA. Solitary idiopathic choroiditis: findings on enhanced depth imaging optical coherence tomography in 10 cases. Ophthalmology 2013;120:852–8.
Fung AT, Waldstein SM, Gal-Or O, Pellegrini M, Preziosa C, Shields JA, et al. Focal scleral nodule: a new name for solitary idiopathic choroiditis and unifocal helioid choroiditis. Ophthalmology 2020;127:1567–77.
Goyal S, Ware GT, Petrovic V. Coxsackie virus a possible missing link to unifocal helioid choroiditis? Clin Exp Ophthalmol. 2015;43:377–9.
Kumar V, Khoo CT, Shields CL. SOLITARY IDIOPATHIC CHOROIDITIS IN THE SETTING OF EXTENSIVE ANIMAL EXPOSURE. Retin Cases Brief Rep. 2016;10:386–8.
Feng Y, Conrady CD, Demirci H. The evolution of an active solitary idiopathic choroiditis (focal scleral nodule): a case report of the natural course and a review of the literature. BMC Ophthalmol. 2021;21:130.
Duignan E, O’Day R, Moloney T, Rahman W, Damato B. A case series of “solitary idiopathic choroiditis” and proposal of a nomenclature change to “idiopathic scleroma”. Ocul Oncol Pathol. 2021;7:48–53.
Errera MH, Michaelides M, Keane PA, Restori M, Paques M, Moore AT, et al. The extended clinical phenotype of dome-shaped macula. Graefes Arch Clin Exp Ophthalmol. 2014;252:499–508.
Funding
This research was supported by the Basic Science Research Program through the National Research Foundation of Korea under 2019R1A2C2002393 (CSL). The funding organization had no role in the design or conduct of this research.
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Conceptualization, C.S.L; methodology, H.S.P. and C.S.L.; validation, C.S.L.; investigation, H.S.P.; data curation, H.S.P. and C.S.L.; writing—original draft preparation, H.S.P.; writing—review and editing, C.S.L.; supervision, E.Y.C., Y.J.K., S.C.L., S.H.B., S.S.K. and C.S.L.; project administration, C.S.L. All authors have read and agreed to the published version of the manuscript.
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The original online version of this article was revised: The authors have found out that the “Neurosensory layer status, no. (%)” section of Table 2 had unnecessary typos which should have been removed (Normal = 1 Absent = 0 Thinning = 2 Thickening = 3 of the previous table), and that the some of the numbers of this section did not add up to 13. The table was revised, and the result section of the manuscript describing numbers of Table 2 was changed accordingly. Two additional sentences that were found to be including faulty information of the Table 2 were revised based on the information of Table 2. Furthermore, the authors would like the figures of the manuscript to be printed in color rather than black-and-white as it is now since the figure depicts lesions of which color, shape and size can be important factors. The authors are truly sorry for the fact that we were unable to detect the errors during the publication process and the inconvenience this might cause. We thank the editors for the time to be spent on this correction process.
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Park, H.S., Kim, Y.J., Choi, E.Y. et al. Expanded spectrum of focal scleral nodule: focal scleral nodules can be bifocal. Eye 37, 773–778 (2023). https://doi.org/10.1038/s41433-022-02029-y
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DOI: https://doi.org/10.1038/s41433-022-02029-y
