The evolution of an active solitary idiopathic choroiditis (focal scleral nodule): a case report of the natural course and a review of the literature

• Published in: BMC ophthalmology Vol. 21; no. 1; pp. 130 - 4
• Main Authors: Feng, Yilin, Conrady, Christopher D., Demirci, Hakan
• Format: Journal Article
• Language: English
• Published: London BioMed Central 09.03.2021; BioMed Central Ltd; BMC
• Subjects: Acuity; Adolescent; Case Report; Case reports; Choroid; Choroidal granuloma; Choroiditis; Choroiditis - diagnosis; Communicable diseases; Emergency medical care; Ethics; Fluorescein Angiography; Focal scleral nodule; Fundus Oculi; Granuloma; Granulomas; Humans; Infectious diseases; Inflammatory eye diseases; Lesions; Literature reviews; Male; Medical laboratories; Medicine; Medicine & Public Health; Natural history; Nodules; Ocular mass; Ophthalmology; Patients; Solitary idiopathic choroiditis; Tomography, Optical Coherence; Tuberculosis; Uveitis; Focal scleral nodule; Granuloma; Ocular mass; Solitary idiopathic choroiditis; Choroidal granuloma
• ISSN: 1471-2415; 1471-2415
• DOI: 10.1186/s12886-021-01888-5

Background To describe the clinical course of an active solitary idiopathic choroiditis (focal scleral nodule) that nearly resolved over six weeks without intervention. Case presentation An 18-year-old man presented to the emergency department with headaches and new onset central scotoma in the right eye. Visual acuity was 20/20 in both eyes. Fundus examination revealed an amelanotic choroidal lesion with associated shallow subretinal fluid. It measured 6.1 × 6.3 × 1.4mm on A- and B-scan. Evaluation for systemic inflammatory and infectious diseases was negative. A week later, the lesion remained stable, and a month later, there was improvement of the lesion with a decrease in size on OCT and exam and resolution of the subretinal fluid suggesting that the lesion had become inactive. Conclusions Solitary idiopathic choroiditis (Focal scleral nodule) is a rare condition characterized by inflammatory granulomatous reaction. This case report sheds light on the unknown natural course of a solitary idiopathic choroiditis (focal scleral nodule).