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