Expanded spectrum of focal scleral nodule: focal scleral nodules can be bifocal

Hyo Song Park, Yong Joon Kim, Eun Young Choi, Sung Chul Lee, Suk Ho Byeon, Sung Soo Kim, Christopher Seungkyu Lee

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


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.

Original languageEnglish
Pages (from-to)773-778
Number of pages6
JournalEye (Basingstoke)
Issue number4
Publication statusPublished - 2023 Mar

Bibliographical note

Funding Information:
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.

Publisher Copyright:
© 2022, The Author(s), under exclusive licence to The Royal College of Ophthalmologists.

All Science Journal Classification (ASJC) codes

  • Ophthalmology
  • Sensory Systems


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