Posterior Scleral Bowing With XXXX on Enhanced-Depth Imaging Optical Coherence Tomography.

@entity1 @entity5 @entity2118 @entity3193 @entity5995
Importance: Recognition of posterior scleral bowing with @entity3193 is essential to avoid an underestimation of @entity5 thickness. Objective: To describe a particular observation of posterior scleral bowing associated with @entity3193 on enhanced-depth imaging (EDI) optical coherence tomography (OCT). Design, Setting, and @entity1 : Retrospective observational case series at a referral center involving 17 eyes of 17 @entity1 . @entity1 were seen from June 2013 to July 2014, with all data collected and analyzed from June 2014 to July 2014. Interventions: Retrospective medical record review and multimodal imaging including fundus photography, autofluorescence, infrared reflectance, ultrasonography, and EDI-OCT. Main Outcomes and Measures: Clinical and imaging characteristics. Results: Analysis of 318 consecutive @entity1 with @entity3193 imaged over a 1-year period revealed that 17 cases (5%) demonstrated the EDI-OCT feature of posterior scleral bowing. Of these 17 cases, the mean @entity1 age was 58 years (median, 58 years; range, 36-75 years) and there were 6 @entity1 (35%) and 11 @entity1 (65%). The nevus was classified as pigmented (n   =   3; 18%), nonpigmented (n   =   2; 12%), and mixed @entity2118 (n   =   12; 71%), and with no surrounding halo (n   =   7; 41%). Associated features included overlying drusen (n   =   9; 53%), @entity5995 pigment epithelial alterations (n   =   9; 53%), subretinal fluid (n   =   5; 29%), and orange pigment (n   =   3; 18%). The nevus was clinically estimated to be of 4.91-mm basal dimension and measured ultrasonographically at 1.59-mm thickness. By EDI-OCT, the nevus mean thickness was 628   m (0.63 mm). All cases demonstrated posterior scleral bowing with mean scleral excavation of 398   m (median, 377   m; range, 134-739   m). Underlying the nevus, the scleral thickness was not measurable; however, at the nevus margin, the choroid and sclera appeared normal. Clinical features correlated with posterior scleral bowing included reduced distance to the optic disc (difference, 1.3 mm; 95% CI, -2.95 mm to 5.51 mm; P   =   .01) and the foveola (difference, 2.14 mm; 95% CI, 0.80 mm to 3.48 mm; P   <   .001), as well as the presence of surrounding halo (difference, 36%; 95% CI, 16.86% to 59.27%; P   <   .001). Conclusions and Relevance: @entity3193 can show focal posterior scleral bowing on EDI-OCT in 5% of cases. This finding was related to more posterior location of nevus, less/mixed @entity2118 , and surrounding halo. This finding could lead to underestimation of @entity5 thickness as the @entity5 bows backward rather than forward.
