Wong Claire M, Kawasaki Brian S
*OD †OD, MBA, FAAO VA Southern Nevada Healthcare System (CMW), North Las Vegas, Nevada; Southern California College of Optometry (CMW, BSK), Fullerton, California; and Illinois College of Optometry (BSK), Chicago, Illinois.
Optom Vis Sci. 2014 Feb;91(2):e32-7. doi: 10.1097/OPX.0000000000000125.
Sclerochoroidal calcification is a rare ocular condition characterized by multifocal, yellow-white elevated fundus lesions typically located in the superotemporal quadrant along the superior arcades. The pathology of calcification can be classified as dystrophic, metastatic, or idiopathic. Vision-threatening complications may arise, such as choroidal neovascular membrane and serous retinal detachment. The pathogenesis of sclerochoroidal calcification remains unclear.
A 72-year-old Caucasian male patient presented to the clinic for routine examination. Fundus evaluation revealed bilateral, multifocal, pale yellow elevated lesions in the superotemporal fundus. Ultrasonography showed a focal area of hyper-reflectivity located in the posterior retina of both eyes, and optical coherence tomography showed an intact retina overlying the elevated lesions in the choroid. Systemic evaluation for dystrophic and metastatic calcification was negative, and the patient was diagnosed with idiopathic sclerochoroidal calcification.
It is important to distinguish sclerochoroidal calcification from other conditions to prevent unnecessary intervention. Calcification of body tissues warrants a systemic evaluation, including screening for calcium and phosphorous levels, to rule out underlying systemic disease. If a biochemical abnormality is discovered, it can be appropriately treated with supplements. If calcification is deemed idiopathic, then annual dilated examinations are recommended to monitor the fundus lesions. Visual prognosis for sclerochoroidal classification is good, as the lesions are typically located away from the macula and foveal encroachment is rare.
巩膜脉络膜钙化是一种罕见的眼部疾病，其特征为多灶性、黄白色隆起的眼底病变，通常位于颞上象限沿上血管弓处。钙化的病理可分为营养不良性、转移性或特发性。可能会出现威胁视力的并发症，如脉络膜新生血管膜和浆液性视网膜脱离。巩膜脉络膜钙化的发病机制尚不清楚。
一名72岁的白种男性患者到诊所进行常规检查。眼底评估发现双侧颞上眼底有多灶性淡黄色隆起病变。超声检查显示双眼后极视网膜有一个局灶性高反射区，光学相干断层扫描显示脉络膜隆起病变上方的视网膜完整。对营养不良性和转移性钙化的全身评估为阴性，该患者被诊断为特发性巩膜脉络膜钙化。
将巩膜脉络膜钙化与其他疾病区分开来以避免不必要的干预很重要。身体组织的钙化需要进行全身评估，包括筛查钙和磷水平，以排除潜在的全身性疾病。如果发现生化异常，可以适当补充进行治疗。如果钙化被认为是特发性的，建议每年进行散瞳检查以监测眼底病变。巩膜脉络膜钙化的视力预后良好，因为病变通常远离黄斑，很少侵犯黄斑中心凹。
