Bilateral Multifocal Scleral Nodules

Shen, Carl; Seamone, Mark E.

doi:10.1001/jamaophthalmol.2022.4402

Cited by 1 publication

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“…One should be aware of this as they may mimic choroiditis lesions of other infectious or immune-mediated as well as noninflammatory conditions like tuberculosis, sarcoidosis, bird shot chorio-retinopathy (BCR), and focal or multifocal scleral nodules. [ 13 , 14 ] History of HZO and normal other eye examination, as well as the treatment outcomes and long-term follow-up, would give important differentiating clues in challenging cases. Interestingly, Bodaghi et al .…”

Section: Discussionmentioning

confidence: 99%

Choroidal lesions in varicella zoster virus uveitis

Kawali

Khanum

Mahendradas

et al. 2023

Indian Journal of Ophthalmology

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Purpose: To evaluate choroidal lesions with spectral domain optical coherence tomography (SD-OCT) scan in varicella zoster virus (VZV) uveitis. Methods: VZV-uveitis cases which underwent OCT scan for choroidal lesions were studied. SD-OCT scan passing through these lesions was studied in detail. Subfoveal choroidal thickness (SFCT) during active and resolved stages was studied. Angiogaphic features were studied where available. Results: Thirteen out of 15 cases had same-sided herpes zoster ophthalmicus skin rashes. All except three patients had old or active kerato-uveitis. All eyes demonstrated clear vitreous and a single or multiple hypopigmented orangish-yellow choroidal lesions. The number of lesions remained unchanged during the follow-up on clinical examination. SD-OCT over lesions ( n = 11) showed choroidal thinning ( n = 5), hyporeflective choroidal elevation during active inflammation ( n = 3), transmission effects ( n = 4), and ellipsoid zone disruption ( n = 7). The mean change in SFCT ( n = 9) after resolution of the inflammation was 26.3 μm (range: 3–90 μm). Fundus fluorescein angiography showed iso-fluorescence over lesions in all ( n = 5), but indocyanine green angiography ( n = 3) showed hypofluorescence at lesions. Mean follow-up was 1.38 years (range: 3 months–7 years). De-novo appearance of choroidal lesion during the first relapse of VZV-uveitis was captured in one case. Conclusion: VZV-uveitis can cause focal or multifocal hypopigmented choroidal lesions with thickening or scarring of choroidal tissue, depending on the disease activity.

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Section: Discussionmentioning

confidence: 99%