Bilateral Sclerochoroidal Calcifications: A Case Report

Purpose: The aim of this case report is to describe a rare condition of bilateral sclerochoroidal calcification Case Report: A 79 years old asymptomatic Caucasian female was referred to our Ocular Oncology Center of the Ophthalmic Surgery Department of Pisa on November 2021. She was in apparent good health. Funduscopic examination revealed yellowwhite irregular lesions in the supero-temporal quadrant of both eyes. Best-corrected visual acuity was 20/20. B-scan and A-scan ultrasound revealed hyper-echoic solid lesions with acoustic orbital shadowing measuring 1.5 mm in thickness and 4.6 mm in diameter, on average. Enhanced Deep Imaging Optical Coherence Tomography showed a scleral lesion compatible with the presence of deposition of calcium with Table Mountain and rolling pattern. Fluorescein angiography revealed hypofluorescence in the arterial phase and a mild hyper-fluorescence in the venous phase with persistent late staining. Indocyanine green angiography showed hypo-fluorescence at the early, middle, and late phases. Systemic investigation of calcium and phosphate metabolism was performed and the patient didn’t display any underlying systemic disorder. Conclusion: It is important to know and recognize this condition. Although most cases of sclerochoroidal calcifications may be idiopathic, systemic laboratory workup must be performed to exclude calcium-phosphate metabolic disorder that can be associated to these ocular signs. Given the rare possible development of choroidal neovascularization, regular imaging checkup is recommended.