Sclerochoroidal Calcification

Abstract

Background: Sclerochoroidal calcification is an unusual ocular condition that is believed to be idiopathic in most cases. Objectives: To describe the clinical manifestations of sclerochoroidal calcification and to investigate its possible systemic associations. Methods: This noncomparative consecutive case series included patients diagnosed as having sclerochoroidal calcification based on clinical characteristics and diagnostic test findings. We analyzed the demographic, systemic, and ocular features of 27 such patients. Systemic evaluation included tests for calcium-phosphorus metabolism in 19 patients and renal tubular hypokalemic metabolic alkalosis syndromes (Bartter or Gitelman syndrome) in 13. Results: All the patients were asymptomatic older (mean age, 70 years) white individuals, incidentally noted as having a choroidal lesion on routine examination. Among 38 eyes, the main referral diagnoses were choroidal metastasis in 10 eyes (26%), choroidal melanoma in 8 (21%), and choroidal nevus in 4 (11%). Sixteen patients (59%) had unilateral clinical findings, while 11 (41%) had bilateral. The Snellen visual acuity was 20/50 or better in 37 eyes (97%). Cogan scleral plaque was visible anterior to the insertion of horizontal rectus muscles in 10 eyes (26%). Among 77 foci, there were a mean of 2 foci of sclerochoroidal calci

Multimodal Imaging of Choroidal Neovascularization Associated with Sclerochoroidal Calcification

“…The lesion was treated with argon laser photocoagulation, and there was no recurrence over the 7-year follow-up period. In their case series of 38 eyes with SCC, Honavar et al [1] found only 1 case of CNVM, which did not affect central visual acuity and remained stable without treatment through 1 year of follow-up.…”

“…Sclerochoroidal calcification (SCC) is a benign ocular condition often noted incidentally on examination of elderly individuals [1]. Clinically, it is characterized by yellow or yellow-white lesions in the postequatorial fundus, most often in the superotemporal quadrant, which commonly appear flat but can also be elevated, mimicking a choroidal tumor.…”

Differential diagnosis for chronic hypokalaemia

“…In this case, the patient presented later in life with sclerochoroidal calcification, which has been reported to be associated with GS 7. The suggested mechanism is that the sclerochoroidal lesions are crystal deposits of calcium pyrophosphate dihydrate, which possibly develop as a consequence of hypomagnesaemia 7. These same deposits have been shown to accumulate in joints, causing pseudogout or chondrocalcinosis 7…”

“…It can present with symptoms such as salt craving, musculoskeletal cramps, muscle weakness, aches, fatigue, dizziness, nocturia and polydipsia 6. In this case, the patient presented later in life with sclerochoroidal calcification, which has been reported to be associated with GS 7. The suggested mechanism is that the sclerochoroidal lesions are crystal deposits of calcium pyrophosphate dihydrate, which possibly develop as a consequence of hypomagnesaemia 7.…”

Review of choroidal osteomas

“…Also lacking distinct margins are the amelanotic choroidal nevi and metastatic carcinomas, with the latter usually associated with a large serous retinal detachment. Moreover, idiopathic sclerochoroidal calcification is rather multifocal in pattern and is more likely to be bilateral compared to choroidal osteoma 341…”