A case of chorioretinal atrophy due to sclerochoroidal calcification

Diagnosis and Management Strategies in Sclerochoroidal Calcification: A Systematic Review

Sclerochoroidal calcification (SCC) is a rare disease which is characterized by calcium deposition in the sclera. The choroid is secondarily involved. Typical localization is in the midperipheral region, outside the vascular arcades. SCC is mostly located in the superotemporal quadrant. Often times, the patients are referred with the diagnosis of an amelanotic tumor. SCC may be dystrophic or metastatic. Metastatic SCC lesions are associated with conditions altering calcium and phosphate metabolism including primary and secondary hyperparathyroidism, vitamin D intoxication, renal failure, hyperphosphatemia, and destructive bony lesions. SCC lesions have a characteristic appearance and appear as distinct, ill-defined, yellow-white, elevated scleral/choroidal masses funduscopically. The purpose of this literature review is to review the current knowledge on SCC, highlight the imaging features, and discuss the differential diagnosis as well as management options.

A Case of Extensive Bilateral Idiopathic Sclerochoroidal Calcification and Review of Literature

A 62-year-old Caucasian male was referred to retina for choroiditis and uveitis. Multiple areas of yellow irregularities were noted on fundus exam throughout the periphery of both eyes, corresponding to lesions at the sclerochoroidal junction on OCT. A diagnosis of sclerochoroidal calcifications (SCC) was confirmed by B-ultrasonography, fundus photography, OCT imaging, and fluorescein and indocyanine green angiography. Systemic metabolic studies were performed, which showed reduced renal function with increased serum calcium; however, SCC lesions in this case were most likely idiopathic. In this work, we report the clinical findings, appearance on multimodal imaging, and systemic associations of sclerochoroidal calcification. Sclerochoroidal calcifications are an unusual clinical finding that tends to be idiopathic, but a focused workup and specialist referral may be warranted to exclude systemic conditions associated with abnormal calcium-phosphate metabolism or hypokalemic metabolic alkalosis syndromes.