Classification of Sclerochoroidal Calcification Based on Enhanced Depth Imaging Optical Coherence Tomography “Mountain-Like” Features

Hasanreisoğlu, Murat; Saktanasate, Jarin; Shields, Patrick W.; Shields, Carol L.

doi:10.1097/iae.0000000000000468

Cited by 26 publications

(41 citation statements)

References 12 publications

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“…B-scan ultrasonography demonstrating acoustic shadowing characteristic of calcification can help confirm the diagnosis. Enhanced-depth optical coherence tomography (OCT) shows the lesions arising from the sclera with thinning or absence of the overlying choroid [4]. In the vast majority of cases, SCC is idiopathic but may be associated with secondary causes of hypercalcemia.…”

Section: Introductionmentioning

confidence: 99%

Multimodal Imaging of Choroidal Neovascularization Associated with Sclerochoroidal Calcification

Bessette

Singh²

2016

Ocul Oncol Pathol

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We report a case of a choroidal neovascular membrane (CNVM) associated with sclerochoroidal calcification (SCC). An asymptomatic, 72-year-old male was referred to our institution for yellow-white placoid retinal lesions of both eyes. B-scan ultrasonography confirmed the diagnosis of SCC, and indocyanine green angiography confirmed the presence of an associated CNVM. Due to enlargement of a hemorrhagic pigment epithelial detachment associated with the CNVM over the course of 7 months, the patient was treated with a series of bevacizumab injections followed by photodynamic therapy (PDT). Due to persistence of the CNVM following PDT, the lesion was finally treated with argon laser photocoagulation. We describe the clinical course of this rare complication of SCC.

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Section: Introductionmentioning

confidence: 99%

Multimodal Imaging of Choroidal Neovascularization Associated with Sclerochoroidal Calcification

Bessette

Singh²

2016

Ocul Oncol Pathol

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“…As the area of scleral calcification progresses, it eventually displaces the overlying choroidal and retinal tissue. EDI‐OCT can reveal the extent of anterior displacement of the overlying tissues, seen as choroidal thinning at the apex of the tumour . EDI‐OCT of sclerochoroidal calcification reveals an ill‐defined subchoroidal lesion, the lateral margins of which cannot be readily distinguished but often a clear anterior margin remains continuous with the choroid‐scleral junction line (Figure B).…”

Section: Discussionmentioning

confidence: 99%

Multimodal imaging of suspicious choroidal neoplasms in a primary eye‐care clinic

Kaur

Anthony

2017

Clinical and Experimental Optometry

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Small suspicious choroidal neoplasms commonly present a diagnostic challenge in primary eye-care clinics, where they are most likely to present. Differentiating benign from malignant choroidal neoplasms is essential for facilitating early diagnosis and treatment, potentially decreasing the risk of metastasis and vision loss in some cases. The purpose of this review is to describe the clinical, spectral-domain optical coherence tomography and fundus autofluorescence features of suspicious choroidal neoplasms in a case series of patients presenting to a primary eye-care clinic at the Veterans Health Administration, Cleveland, Ohio, USA.Key words: benign choroidal neoplasm, choroidal melanoma, choroidal metastasis, choroidal naevus, fundus autofluorescence, optical coherence tomography, sclerochoroidal calcification Primary eye-care providers are likely to encounter patients with suspicious choroidal lesions during routine clinical examination. The choroid can be a harbour of malignant neoplasms, such as choroidal melanoma and metastasis.1 Other benign choroidal lesions may have overlapping clinical features that mimic malignancies, many times precluding an accurate diagnosis and requiring consultation with a retinal or ocular oncology ophthalmologist. With access to high-resolution spectral-domain optical coherence tomography (SD-OCT), optometrists are able to evaluate microstructural retinal and choroidal changes, allowing better characterisation of suspicious choroidal lesions. SD-OCT is also used to perform enhanced-depth imaging OCT (EDI-OCT) to increase the resolution of structures posterior to the retinal pigment epithelial (RPE) layer, specifically the choroid and sclera, further expanding the ability to evaluate subretinal lesions. Fundus autofluorescence is another useful imaging tool for evaluating retinal changes associated with choroidal lesions. Fundus autofluorescence highlights the presence of lipofuscin, a clinical finding known to have strong association with malignant choroidal lesions. SD-OCT systems such as Topcon 3D OCT-2000 (Topcon Medical Systems, Inc., Oakland, New Jersey, USA) and Heidelberg Spectralis HRA+OCT (Heidelberg Engineering, Heidelberg, Germany) are equipped with fundus autofluorescence imaging, which is able to highlight areas of RPE distress caused by the underlying effects of invasive or spaceoccupying choroidal lesions. Combined analysis of SD-OCT and fundus autofluorescence, referred to as multimodal imaging, can enhance the evaluation process for suspicious choroidal lesions, possibly facilitating an earlier diagnosis and conversely, preventing false-positive referrals for benign choroidal lesions. Herein, we describe the clinical, SD-OCT and fundus autofluorescent features of small suspicious choroidal neoplasms and mimicking lesions, both benign and malignant, in a case series of patients presenting to a primary eye-care clinic at the Veterans Health Administration, Cleveland, Ohio, USA. METHODSof the choroidal neoplasm was plotted manually at the location judged to b...

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“…Based on enhanced depth optical coherence tomography sclerochoroidal calcification was described as a scleral-based disease and could be classified based on four "mountain-like" topographic patterns. They include flat (Type 1) (n=9) at median thickness of 1.2 mm, rolling (Type 2) (n=28) at 1.4 mm thickness, rocky-rolling (Type 3) (n=21) at 2.1 mm thickness and table mountain (Type 4) (n=9) at a thickness of 1.9 mm [5,7]. Rarely sight-threatening complications that have been reported with sclerochoroidal calcification include choroidal neo-vascularization and serous detachments.…”

Section: Discussionmentioning

confidence: 99%

Sclerochoroidal Calcification: Parathyroid Connection

Yaturu¹,

Potluri²,

Alstine³

2017

J Med Surg Pathol

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Objective: Sclerochoroidal calcification is a benign condition often noted incidentally on ophthalmoscopic examination of the fundus. It may be associated with metabolic disorders such as hyperparathyroidism, Gitelman syndrome, pseudo hypoparathyroidism. Here we present a case of asymptomatic Sclerochoroidal calcification incidentally found on a routine fundoscopic examination of a patient with diabetes and primary hyperparathyroidism. Methods: The following is a case report with a review of the literature. Results: 62 year old Caucasian male was referred to Endocrine section from ophthalmology for work up of possible secondary causes of an incidental finding of sclerochoroidal calcification noted on routine exam for diabetic retinopathy in 2015. The lesion was present in prior fundus photos from 2011 with no significant changes, indicating stability of the lesion over the last 4 years. Ophthalmic exam noted all normal findings for pupillary reaction, extraocular motility, intra ocular pressures, visual fields and acuity of vision was 20/20 in both eyes and there was no evidence of diabetic retinopathy on dilated fundus exam. An incidental finding of an elevated round yellow lesion superior to the optic nerve head was noted on the fundus exam in the left eye behind the lesion consistent with dense intra-lesional calcification. The lesion did not demonstrate any abnormal vasculature, pigmentation, or retinal fluid. Ophthalmic ultrasonography testing revealed hyper-reflectivity with acoustic shadowing. On work up found to have primary hyperparathyroidism. Whether they are related or incidental problems together is not clear. Conclusion: Though Sclerochoroidal calcification can be idiopathic in most cases, clinicians are advised to rule out metabolic disorders such as abnormal calcium and phosphorous metabolism.

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Classification of Sclerochoroidal Calcification Based on Enhanced Depth Imaging Optical Coherence Tomography “Mountain-Like” Features

Abstract: In this report, enhanced depth optical coherence tomography has demonstrated that sclerochoroidal calcification is a scleral-based disease and can be classified based on four "mountain-like" topographic patterns, associated with variable effects on the choroid and retina.

Cited by 26 publications

References 12 publications

Multimodal Imaging of Choroidal Neovascularization Associated with Sclerochoroidal Calcification

Multimodal Imaging of Choroidal Neovascularization Associated with Sclerochoroidal Calcification

Multimodal imaging of suspicious choroidal neoplasms in a primary eye‐care clinic

Sclerochoroidal Calcification: Parathyroid Connection

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