Sclerochoroidal calcification associated with chondrocalcinosis: A clinical case

Area of Science:

• Ophthalmology
• Rheumatology
• Medical Imaging

Background:

• Sclerochoroidal calcifications involve calcium and phosphate deposition in the sclera and choroid, primarily affecting elderly individuals.
• While often idiopathic, these calcifications can stem from systemic disorders affecting phosphocalcic metabolism, necessitating thorough medical evaluation.
• Early identification is key to distinguishing these benign findings from sight-threatening conditions like choroidal metastasis.

Observation:

• A 65-year-old patient with known articular chondrocalcinosis presented for routine optical correction.
• Funduscopic examination revealed bilateral, supra-macular, tumor-like choroidal lesions.
• Ultrasound confirmed the calcific nature of the lesions, while angiograms showed no active neovascularization.

Findings:

• The case highlights a link between sclerochoroidal calcifications and articular chondrocalcinosis.
• Two types of sclerochoroidal calcifications exist: plaque-type and pseudotumor-type, often presenting as bilateral yellowish lesions.
• Despite the potential for a tumor-like appearance, these calcifications are typically asymptomatic and have a good visual prognosis if located away from the macula.

Implications:

• Routine fundus examinations are recommended for patients diagnosed with chondrocalcinosis to screen for sclerochoroidal calcifications.
• Accurate diagnosis is vital to avoid unnecessary aggressive treatments for conditions mimicking choroidal metastasis or achromic melanoma.
• This case underscores the importance of a comprehensive metabolic work-up in patients with suspected sclerochoroidal calcifications.