Ocular involvement in tumoral calcinosis

Area of Science:

• Ophthalmology
• Rheumatology
• Medical Imaging

Background:

• A 32-year-old male presented with a 1.5-year history of progressive blurred vision in his right eye.
• The patient reported migratory swelling over large joints, some resolving after chalky white discharge, with persistent swelling in the gluteal region.

Observation:

• Ophthalmological examination showed severely reduced visual acuity (counting fingers at 1 meter) in the right eye.
• Perilimbal conjunctival calcific deposits and retinal angioid streaks were noted in both eyes.
• Fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) confirmed a choroidal neovascular membrane with subretinal hemorrhage in the right eye.

Findings:

• B scan ultrasonography and vector A scan revealed calcification of the subretinal neovascular membrane.
• Calcification extended to the adjoining sclera, suggesting a widespread calcification process.
• The ocular findings were associated with a history of systemic inflammatory and suppurative joint disease.

Implications:

• This case highlights a potential link between systemic calcific deposition, possibly related to inflammatory arthropathy, and ocular complications like choroidal neovascularization.
• Early detection and comprehensive imaging are crucial for diagnosing and managing such rare conditions.
• Further research is warranted to understand the pathogenesis of this systemic-ocular calcification syndrome.