Download PDF

Make your diagnosis in the comments, and look for the answer in next month’s Blink.

Last Month’s Blink

Sclerochoroidal Calcification

Written by Hongan Chen, MD, and Scott C.N. Oliver, MD. Photos by Heather Olson. All are at Sue Anschutz-Rodgers Eye Center, University of Colorado Anschutz Medical Campus, Aurora.

A 71-year-old woman with a past medical history significant for type 2 diabetes and colon cancer that had been treated with partial colectomy was referred for further evaluation of an asymptomatic subretinal lesion in her left eye. Anterior segment examination was unremarkable. The fundus exam showed an elevated white, nodular subretinal lesion abutting the superotemporal macula, with mild overlying pigment (Fig. 1). OCT revealed a homogeneous “rocky-rolling” scleral lesion with overlying areas of choroidal thinning. Retinal structure was pre­served, including the temporal fovea elevated by the lesion (Fig. 2). The scleral lesion was mea­sured as having a 3-mm apical height on B-scan ultrasonography and demonstrated hyperechoge­nicity with posterior shadowing and high internal reflectivity (Fig. 3).

Upon further questioning, our patient stat­ed that she had experienced a single episode of hypercalcemia of unclear etiology. Given the systemic associations of sclerochoroidal calcifica­tion, the patient was referred to follow up with her primary care physician to check serum levels of parathyroid hormone, calcium, magnesium, and phosphate.

Learn more on EyeWiki at eyewiki.org/Sclerochoroidal_Calcification.

Read your colleagues’ discussion.