Retrospective case report on asymptomatic sclerochoroidal calcification

Methods and Materials: Retrospective Case Report

Sclerochoroidal calci?ca2on is a rare, benign condi2on characterised by calcium deposi2on within the sclera, typically in elderly pa2ents, and is o>en discovered incidentally. It can masquerade as a re2nal or choroidal mass, leading to unnecessary referrals and inves2ga2ons. We report a case of asymptoma2c sclerochoroidal calci?ca2on iden2?ed following referral for a suspected re2nal lesion detected during a rou2ne op2cian visit. Visual acuity was una?ected, and anterior segment examina2on was unremarkable. Colour fundus photography demonstrated a well-de?ned, yellow-white, elevated lesion located in the superotemporal posterior pole, with smooth margins and no associated subre2nal ?uid, haemorrhage, or pigmentary disturbance. The lesion’s loca2on corresponded anatomically to the site of oblique extraocular muscle inser2on, a recognised predilec2on site for sclerochoroidal calci?ca2on. Mul2modal imaging was undertaken to further characterise the lesion. Op2cal coherence tomography revealed focal underlying choroidal thinning without eleva2on of the re2nal layers; there was no disrup2on of the re2nal architecture. Fundus auto?uorescence imaging demonstrated a corresponding area of hypoauto?uorescence, consistent with dense calci?ca2on. B-scan ultrasonography showed a highly re?ec2ve lesion with posterior acous2c shadowing.

Results: Given the characteris2c clinical appearance, imaging ?ndings, and typical anatomical loca2on, a diagnosis of sclerochoroidal calci?ca2on was established. Systemic evalua2on did not iden2fy any associated metabolic or endocrine abnormali2es, including disorders of calcium or phosphate metabolism. The pa2ent was reassured, and observa2on at 6 months follow up did not show any changes.

Conclusion: This case illustrates the importance of recognising sclerochoroidal calci?ca5on as a benign en5ty and highlights the value of wide?eld imaging and mul5modal assessment in di?eren5a5ng it from sight-threatening choroidal pathology. Awareness of its typical imaging features and predilec5on for sites of extraocular muscle inser5on can prevent misdiagnosis, unnecessary inves5ga5ons, and pa5ent anxiety.