Nabih O, Hamdani H, El Maaloum L, Allali B, El Kettani A
Medical Resident at Pediatric Ophthalmology Department, Ho^pital 20, Aou^t, 1953, Casablanca, Morocco.
Ann Med Surg (Lond). 2022 Jan 29;74:103275. doi: 10.1016/j.amsu.2022.103275. eCollection 2022 Feb.
Sclerochoroidal calcifications is a rare condition corresponding to senile plaques due to the deposition of calcium and phosphate in the sclera and choroid. It is an elderly patient's pathology. In most cases, it is idiopathic. However, some patients have systemic disorders leading to disturbances in phosphocalcic metabolism, which are at the origin of this disorder. A check-up is therefore necessary to detect them.
We report the case of a 65 year old patient admitted to the ophthalmology department for a renewal of optical correction. The patient is known to have articular chondrocalcinosis on anti-inflammatory medication. Fundus examination revealed multiple white supra macular choroidal lesions with tumour-like appearance in both eyes. The ultrasound perfomed showed the calcic nature of the lesions. Fluorescein and indocyanine green angiograms showed no sign of activity or presence of neovessels.A complete metabolic work-up, mainly phosphocalcic, was ordered again and the systemic diagnosis of articular chondrocalcinosis was retained.
Shields et al. first described, in 1997, a case of sclerochoroidal calcification in a patient with chondrocalcinosis and a normal metabolic profile. Few more have been added to the literature. It is generally considered to be predominantly bilateral and is most often seen as yellowish lesions. Two types of calcifications have been described to date, the plaque type and the pseudotumor type. Given the asymptomatic presentation, a fundus examination should be performed in patients with chondrocalcinosis. Generally, no treatment is necessary.
Sclerochoroidal calcifications usually manifests as multiple discrete yellow placoid lesions in elderly asymptomatic patients. Visual prognosis for sclerochoroidal classification is good since the lesions tend to be away from the macula. They should not be confused with choroidal metastasis or achromic melanoma which require more extensive treatment.
巩膜脉络膜钙化是一种罕见病症，对应于由于钙和磷酸盐在巩膜和脉络膜中沉积而形成的老年斑。它是老年患者的病症。在大多数情况下，它是特发性的。然而，一些患者患有导致磷酸钙代谢紊乱的全身性疾病，这是该病症的根源。因此有必要进行检查以检测这些疾病。
我们报告一例65岁患者因更换眼镜矫正而入住眼科。该患者已知患有关节软骨钙质沉着症，正在服用抗炎药物。眼底检查发现双眼有多个白色黄斑上脉络膜病变，呈肿瘤样外观。超声检查显示病变具有钙化性质。荧光素和吲哚菁绿血管造影未显示活动迹象或新生血管。再次进行了全面的代谢检查，主要是磷酸钙检查，并维持了关节软骨钙质沉着症的全身诊断。
Shields等人于1997年首次描述了一例患有软骨钙质沉着症且代谢状况正常的患者的巩膜脉络膜钙化病例。此后文献中又增加了少数病例。它通常被认为主要是双侧性的，最常见为淡黄色病变。迄今为止已描述了两种类型的钙化，即斑块型和假肿瘤型。鉴于其无症状表现，对于患有软骨钙质沉着症的患者应进行眼底检查。一般来说，无需治疗。
巩膜脉络膜钙化通常表现为老年无症状患者中的多个离散黄色斑块状病变。巩膜脉络膜钙化的视觉预后良好，因为病变往往远离黄斑。它们不应与需要更广泛治疗的脉络膜转移瘤或无色素性黑色素瘤相混淆。
