Focal Temporal Scleral Bulge with Choroidal Thinning: An Under-Recognized Tomographic Feature
|Rosa Dolz-Marco1*, Roberto Gallego-Pinazo1, Maria Isabel López-Gálvez2, Jose I Tembl3, Manuel Díaz-Llopis4 and Carol Shields5|
|1Department of Ophthalmology, University and Polytechnic Hospital La Fe, Valencia, Spain|
|2Department of Ophthalmology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain|
|3Department of Neurology, University and Polytechnic Hospital La Fe, Valencia, Spain|
|4Faculty of Medicine, University of Valencia|
|5Ocular Oncology Service Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, United States of America (USA)|
|Corresponding Author :||Rosa Dolz-Marco
Department of Ophthalmology
University and Polytechnic Hospital
La Fe. Bulevar Sur s/n. 46026, Valencia, Spain
Tel: 0034 650314806
Email: [email protected]
|Received: February 05, 2015, Accepted: April 15, 2015, Published: April 20, 2015|
|Citation: Dolz-Marco R, Gallego-Pinazo R, López-Gálvez MI, Tembl JI, Díaz-Llopis M (2015) Focal Temporal Scleral Bulge with Choroidal Thinning: An Under-Recognized Tomographic Feature. J Clin Exp Ophthalmol 6:419. doi:10.4172/2155-9570.1000419|
|Copyright: © 2015 Dolz-Marco R, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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Purpose: To describe the swept source tomographic characteristics of focal temporal scleral bulge with choroidal thinning as a normal variation of the ocular anatomy in healthy eyes.
Methods: Cross-sectional observational study. Swept-source optical coherence tomography (SS-OCT) examinations in healthy patients performed between October and December 2013 were analyzed. The presence of a focal scleral bulge with choroidal thickness (CT) variation was evaluated. In those cases with this finding we manually measured the extension of the scleral protuberance and the choroidal shape.
Results: There were 166 eyes of 106 patients analyzed and 13% (22 eyes of 16 patients) demonstrated a focal scleral bulge. The scleral bulge was not visible ophthalmoscopically in any case. By SS-OCT, the scleral bulge had a mean basal diameter of 3225 microns (range 1954-4908 microns) and mean distance temporal to the foveola of 2261 microns (range 1148-4173 microns). Compared to normal submacular scleral thickness, the temporal scleral bulge was a mean of 107 microns thicker (range 31-171 microns). The mean overlying choroidal thickness was 177 microns (range 79-326 microns) compared with mean subfoveal thickness in the involved eye of 250 microns (range 99-431 microns), mean thickness at temporal edge of the bulge of 312 microns (range 195-529 microns). The overlying retinal pigment epithelium and inner retinal contour were normal in all cases.
Conclusions: On SS-OCT, 13% of healthy eyes showed temporal scleral bulge with related choroidal thinning. The clinical significance of this novel sign is under evaluation.