Characteristics

Sclerochoroidal calcification usually occurs in patients over age 50.  Calcifications are white plaque lesions which can sometimes be raised.  They usually occur superotemporally as in the photos on the right, but can occur elsewhere in the fundus.

The differential diagnosis includes choroidal metastases, choroidal nevus, choroidal melanoma, and choroidal osteoma.  The bilaterality of the lesions and there characteristic location is usually enough to rule out a more sinister other diagnosis.

The lesions are benign.  Since they are not near the central vision, the do not affect visual acuity of visual function. 

 

Honavar SG, Shileds CL, Demirci H, Shields JA.  Sclerochoroidal calcification.  Arch Ophthalmol 2001;119:833-840.

Systemic Associations

Hyperparathyroidism, pseudohyperparathyroidism, hypervitaminosis D, pseudogout, and Barttner and Gitelman Syndromes are associated with this disorder.

Testing for metabolic alkalosis, hypokalemia, and abnormal urine electrolytes can suggest Bartter or Gitelman Syndrome.  Blood and urine electrolytes should be evaluated in these patients.

Because of the calcification of the lesions, ultrasound is usually diagnostic.  The lesions are highly reflective and there is usually shadowing behind the lesions.