Sclerochoroidal calcification is a recently recognized ocular condition that is characterized by typical geographic yellow-white fundus lesions that usually occur bilaterally in adults. It can clinically simulate a number of intraocular tumors like choroidal metastasis, choroidal melanoma, and choroidal osteoma. Clinical evaluation with ultrasonography, computed tomography, and some histopathologic studies have supported the fact the condition represents calcium deposition in the sclera and choroid. Early reports suggested that sclerochoroidal calcification was usually associated with hypercalcemic conditions such as hyperparathyroidism and pseudohypoparathyroidism. Subsequently, many patients with sclerochoroidal calcification have had no apparent systemic associations and have been classified as idiopathic. However, very recent studies have suggested that this ocular condition can also be associated with Gitelman syndrome or Bartter syndrome. These are autosomal recessive conditions of hypokalemic alkalosis associated with hypomagnesemia and deposition of calcium salts in various tissues. Ophthalmologists should be familiar with fundus features and systemic associations of sclerochoroidal calcification.
*Director, Ocular Oncology Service, and †Associate Surgeon, Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.
Reprint requests: Jerry A. Shields, MD, Oncology Service, Wills Eye Hospital, 900 Walnut Street, Philadelphia, PA, 19107.
Supported by the Eye Tumor Research Foundation, Philadelphia, PA (C. S. and J. S.) the Award of Merit in Retina Research, Houston, TX (J. S.) and the Macula Foundation, New York, NY (C. S.).
Presented as part of the 2001 Harold Gifford Lecture; Omaha, NB; May 11, 2001.