Bilateral Metastatic Sclerochoroidal Calcification in a Patient with Hyperparathyroidism

Abstract

We present the case of a 39-year-old man with bilateral sclerochoroidal calcification with primary hyperparathyroidism. Both the calcium and parathyroid hormone levels were elevated. Funduscopic examination revealed slightly elevated, multiple yellow lesions in both eyes. Fluorescein angiography showed filling defects of the choroid. Ultrasonography showed elevated, highly reflective lesions, and a computed tomography scan of the globe disclosed sclerochoroidal lesions with high density. We discuss the mechanism of sclerochoroidal calcification.

Diagnosis and Management Strategies in Sclerochoroidal Calcification: A Systematic Review

“…In the late frames, there is usually no leakage (Figure 2D). 4,10 FA also eloquently demonstrates CNV developing…”

Bilateral Multifocal Scleral Nodules

“…SCCs are most commonly present in older women (mean age of 69 years). 1 Younger patients with SCCs tend to have systemic conditions causing calcium abnormalities, 3 with the youngest reported patient in the literature aged 32 years. 1 This patient did not fit the demographic characteristics of patients with SCCs and demonstrated absence of calcium on ultrasonography.…”

“…1 Intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections using pegaptanib and ranibizumab have shown minimal effect on RCHs in lesion size and visual acuity (VA) with variable results on exudation. 2,3 We present 2 cases of peripheral RCHs associated with a series of aflibercept injections, highlighting its potential application as an adjunct treatment in this disease.…”

The eye and the skin in endocrine metabolic diseases

“…135 They include asymptomatic conjunctival calcifications, conjunctivitis, and intraepithelial corneal calcification in the area of the interpalpebral fissure (band keratopathy). 77 Sclerochoroidal calcifications have also been described, being generally asymptomatic and found in occasion of an ocular fundus examination or an orbital computed tomography scan, 136,137 but with the potential of producing late choroidal neovascularization with subretinal exudation. 138 Extensive ocular calcifications have been observed in a case of secondary uremic hyperparathyroidism that had bilateral attenuated and calcified retinal arterioles, calcifications of the bulbar conjunctiva, and unilateral band keratopathy and limbal calcifications.…”