眼科 ›› 2023, Vol. 32 ›› Issue (5): 376-380.doi: 10.13281/j.cnki.issn.1004-4469.2023.05.003

• 专家讲座 • 上一篇    下一篇

局灶性巩膜结节

冉振龙1  彭晓燕2   

  1. 1石家庄爱尔眼科医院,石家庄 050000;2首都医科大学附属北京同仁医院 北京同仁眼科中心 眼科学与视觉科学北京市重点实验室,北京 100730
  • 收稿日期:2023-08-02 出版日期:2023-09-25 发布日期:2023-09-28
  • 通讯作者: 彭晓燕,Email:drpengxy@163.com

Focal scleral nodules

Ran Zhenlong1, Peng Xiaoyan2   

  1. 1 Shijiazhuang Aier Eye Hospital, Shijiazhuang 050000, China; 2 Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing 100730, China
  • Received:2023-08-02 Online:2023-09-25 Published:2023-09-28
  • Contact: Peng Xiaoyan, Email: drpengxy@163.com

摘要:  孤立性特发性脉络膜炎经多模影像证实改称为局灶性巩膜结节,表现为位于眼底后极和赤道之间的黄白色隆起的结节状视网膜下病灶。随后许多研究相继报道了不同形态、数量、转归的局灶性巩膜结节。本病具有高自发荧光、高回声的特性,OCT表现为来自于巩膜的向球内隆起的高反射肿物,OCTA证实其内部无血流信号。其可长时间保持稳定而无需治疗,但易误诊为无色素性的脉络膜病变,特别是在怀疑脉络膜转移癌时。准确识别局灶性巩膜结节有助于眼科医生做出正确的临床决策。本文阐述了局灶性巩膜结节的命名过程、人群分布、多模态影像特征以及鉴别诊断等。(眼科,2023,32: 376-380

关键词: 局灶性巩膜结节, 相干光断层扫描

Abstract: Solitary idiopathic choroiditis (SIC) has been renamed as focal scleral nodule (FSN) based on multimodal imaging findings. FSN presents as yellow-white elevated nodules located between the posterior pole and the equator of the fundus. It exhibits hyperautofluorescent and hyperechogeneic characteristics. On optical coherence tomography (OCT), FSN appears as a highly reflective mass protruding inward from the sclera, and OCT angiography confirms the absence of blood flow within the lesion. FSN can remain stable over a long period without requiring treatment. But it can be misdiagnosed as amelanotic choroidal lesions, especially when there is suspicion of choroidal metastasis. Accurate identification of FSN contributes to making correct clinical decisions for ophthalmologists. This article elucidates the nomenclature process, demographic distribution, multimodal imaging features, and differential diagnosis of FSN. (Ophthalmol CHN, 2023, 32: 376-380)

Key words: focal scleral nodule, optical coherence tomography