Shiwani Haaris A, Memon Danyal, Hayat Usman, Lamin Ali, Finch Kieran, Soorma Talha, El-Nemr Donia, Bilal Loreena, Chaturvedi Ritu, De La Mata Guillermo
Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom.
Royal Victoria Eye and Ear Hospital, Dublin, Ireland ; and.
Retina. 2025 May 1;45(5):979-987. doi: 10.1097/IAE.0000000000004395.
The objective of this study was to add to the limited literature of focal scleral nodule (FSN).
This study was a single-center, retrospective, observational case series performed at Manchester Royal Eye Hospital (United Kingdom). Nineteen eyes from 19 patients over a 13-year period (January 2011 to January 2024) were included. The principal observations were taken from patient demographic data, fundal and autofluorescence imaging, and Enhanced Depth Imaging Optical Coherence Tomography imaging.
Most patients with FSN were female, with median age of 47 years and median visual acuity of 20/20 Snellen. Focal scleral nodules were yellow, yellow-white, orange, or orange halo in appearance. Median horizontal length of a FSN was 2.02 mm (range 0.34-4.79 mm), and median thickness was 417 µ m (range 272-803 µ m). The choroid above the FSN was thinned in nine and absent in 10 cases. Most FSN appeared hyperautofluorescent on autofluorescence imaging. Extramacular FSN appeared directly inferiorly to the optic disc in seven, inferotemporally in five, superonasally in two, and superotemporally in five cases. Seven patients demonstrated FSN within the macula, and two of these had subretinal fluid. Further investigation revealed that one of these patients with subretinal fluid had polypoidal choroidal vasculopathy at the same area as the FSN.
This study analyzed FSN lesions of a medium-sized group over a large timeframe. It provides more data in the literature for an uncommon ophthalmic lesion. Furthermore, the study described the first known case in the literature of FSN with polypoidal choroidal vasculopathy in the same area. This finding highlights a potential new complication of the condition.
本研究的目的是补充关于局限性巩膜结节（FSN）的有限文献。
本研究是在英国曼彻斯特皇家眼科医院进行的一项单中心、回顾性、观察性病例系列研究。纳入了19名患者在13年期间（2011年1月至2024年1月）的19只眼睛。主要观察指标来自患者人口统计学数据、眼底和自发荧光成像以及增强深度成像光学相干断层扫描成像。
大多数FSN患者为女性，中位年龄为47岁，中位视力为20/20 Snellen。局限性巩膜结节外观为黄色、黄白色、橙色或橙色光晕。FSN的中位水平长度为2.02毫米（范围为0.34 - 4.79毫米），中位厚度为417微米（范围为272 - 803微米）。FSN上方的脉络膜在9例中变薄，在10例中缺失。大多数FSN在自发荧光成像上表现为高自发荧光。黄斑外的FSN在7例中位于视盘正下方，在5例中位于颞下，在2例中位于鼻上，在5例中位于颞上。7例患者黄斑区内出现FSN，其中2例有视网膜下液。进一步检查发现，这些有视网膜下液的患者中有1例在与FSN相同区域患有息肉状脉络膜血管病变。
本研究在较长时间范围内分析了一个中等规模组的FSN病变。它为这种罕见的眼科病变在文献中提供了更多数据。此外，该研究描述了文献中首例同一区域FSN合并息肉状脉络膜血管病变的病例。这一发现突出了该病症一种潜在的新并发症。
