Sclerochoroidal calcification involves calcium salt deposits within the sclera, the eye’s tough outer wall, and the choroid, a vascular layer beneath the retina. This benign condition is observed infrequently. It represents a localized calcium accumulation, typically without causing immediate visual disturbances.
Causes and Associated Conditions
The specific cause of sclerochoroidal calcification often remains undetermined, a form referred to as idiopathic sclerochoroidal calcification. This is the most frequently encountered type, often affecting older individuals. These cases are characterized by normal calcium and phosphorus levels in the blood, suggesting the calcification is not due to a systemic metabolic imbalance.
A less common form, secondary sclerochoroidal calcification, arises from underlying systemic health issues that disrupt the body’s calcium and phosphate metabolism. When these pathways are imbalanced, calcium can deposit in various soft tissues, including the eye. Conditions such as primary and secondary hyperparathyroidism, which involve excess parathyroid hormone, can lead to elevated calcium levels and subsequent calcification.
Kidney disorders, including chronic renal failure, also contribute to secondary calcification due to their impact on mineral balance. Genetic conditions like Gitelman syndrome and Bartter syndrome can affect the body’s handling of electrolytes, increasing the risk of these ocular deposits. Other contributing factors include vitamin D intoxication, which can lead to hypercalcemia, and some destructive bony lesions that release calcium into the bloodstream.
Symptoms and Diagnosis
Sclerochoroidal calcification rarely produces noticeable symptoms. The condition is typically discovered incidentally during a routine dilated eye examination, when an ophthalmologist observes the characteristic lesions. These calcifications often appear as flat or slightly elevated yellow placoid masses, sometimes with irregular borders, and are frequently located in the superotemporal midperipheral region of the fundus.
To confirm the diagnosis and distinguish sclerochoroidal calcification from other ocular lesions, ophthalmologists utilize specialized imaging tests. B-scan ultrasonography is a frequently employed method, revealing highly reflective calcium plaques that produce an acoustic shadow behind the lesion. This distinct echogenic pattern helps differentiate calcification from other masses.
Optical coherence tomography (OCT) provides cross-sectional images of the eye’s layers, which may show atrophy of the overlying choroid and retinal pigment epithelium associated with the calcifications. Fundus autofluorescence (FAF) imaging can also be used. These imaging modalities collectively offer detailed views of the calcified areas, aiding in diagnosis.
Management and Prognosis
Sclerochoroidal calcification is a benign condition that typically does not affect vision. The primary management involves periodic observation through follow-up eye examinations. No specific medical or surgical treatment is generally required for the calcifications themselves.
If an underlying systemic condition contributing to the calcification is identified, such as hyperparathyroidism or a renal disorder, treatment will be directed at managing that specific medical issue. This systemic management is typically coordinated by medical specialists, rather than solely by the ophthalmologist. Addressing the root cause can help stabilize overall calcium and phosphate metabolism.
The visual prognosis for individuals with sclerochoroidal calcification is excellent. The condition rarely leads to severe vision-threatening complications. Abnormal blood vessel growth, known as choroidal neovascularization, is an infrequent complication.