The Use of Multimodal Imaging in Detecting Focal Scleral Nodule

Focal scleral nodule was first described in 1997 by Hong et al . as a unifocal helioid choroiditis. However, based on multimodal imaging utilization, the disease was renamed as a focal scleral nodule by Fung et al . in 2020. Focal scleral nodule is a rare, benign, asymptomatic mass commonly found deep to the retina during a routine retinal examination; it originates from the sclera and usually measures one disc diameter and presents near the optic nerve in Caucasian female patients. Even though it originates from the sclera, over 95% of focal scleral nodule patients show overlying choroidal thinning. In this article, we present a case of a 49-year-old Saudi male patient who was found to have a posterior pole lesion; the patient underwent multimodal imaging to help localize and diagnose the condition as a focal scleral nodule. In this article, we present the utilization of multimodal imaging modalities, including optical coherence tomography (OCT), OCT angiography, and indocyanine green angiography, in the diagnosis of focal scleral nodules.