This 81YO female was referred for asymptomatic retinal changes. Vision was 20/50 OD and 20/30 OS.
Color imaging shows bilateral lumpy, elevated subretinal yellow-white nodules extending from the superotemporal maculas into the midperipheries.
OCT scanning through these lesions shows marked hyperreflective scleral thickening with loss of the overlying choroid. These lesions are markedly hyperreflective on B-scan ultrasonography, indicating calcification.
Learning Points:
Sclerochoroidal calcification is a relatively uncommon and benign finding in the elderly population. These yellowish lesions are slightly lumpy and elevated, and usually appear in the mid superior/inferior temporal/nasal quadrants.
The lesions are highly reflective on B-scan ultrasonography and visible on CT. They require no treatment and are not associated with vision loss.
However, they may be associated with systemic hypercalcemic conditions such as hyperparathyroidism and pseudohypoparathyroidism. Shields et al therefore recommended that all such patients be evaluated for underlying systemic calcium disorders (Retina 2015;35:547-554). Although recommended, our patient refused this blood work.
