Focal ossification as one of the reasons for erroneous diagnosis of chorioretinal lesions

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Abstract

Focal calcifications of the retina and choroid occur usually in such well-known tumors as: retinoblastoma, choroidal osteoma, choroidal hemangioma, retinal astrocytoma. In addition, cases of idiopathic or secondary calcification are known, the most common of them is sclerochoroidal calcification. The article provides a detailed analysis of the clinical and tomographic pictures of ossifying conditions occurring in adults. It is shown that, in addition to a different ophthalmoscopic picture, these conditions are characterized by a different level of localization of the pathological calcification zone and a different stage of retinal damage.

About the authors

Alevtina S. Stoyukhina

Research Institute of Eye Diseases

Author for correspondence.
Email: a.stoyukhina@ya.ru
ORCID iD: 0000-0002-4517-0324

PhD, Senior Research Associate of Department of Retina and Optical Nerve Patology. Ophthalmology Department

Russian Federation, 119021, Moscow, Rossolimo St., 11 A,B

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Supplementary files

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2. Fig. 1. Right (а) and left (b) eye fundus photo of patient B., 72 years old, with bilateral multifocal sclerochoroidal calcification

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3. Fig. 2. Fundus photo of patient Sh., 59 years old at first visit, and after 38 months follow-up (green arrows – borders of the first focus, blue arrows – borders of the second focus)

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4. Fig. 3. Optical coherence tomography of the patient B. (72 years old). Horizontal scan across sclerochoroidal calcification. Green arrows – “spiky” Bruch’s membrane profile, blue arrows – Bruch’s membrane “entrapment” area

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5. Fig. 4. Optical coherence tomography of the patient T. (64 years old). Horizontal scan across sclerochoroidal calcification. Arrows – area of retinal damage, visualization of the outer border of the underlying choroid is impaired

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6. Fig. 5. Optical coherence tomography of the patient Sh. (59 years old). Horizontal scan across sclerochoroidal calcification. Arrow – thinning of the choroid and the zone of Bruch’s membrane “entrapment”; dotted line – hyporeflective structure under a thinned choroid

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7. Fig. 6. Right (a) and left (b) eye fundus photos of patient G., 22 years old, with bilateral choroidal osteoma. Arrow – choroidal neovascularization

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8. Fig. 7. Fungus photo of patient N., 35 years old. Arrow – choroidal neovascularization

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9. Fig. 8. Fundus photo of patient Ch., 21 years old. Arrow – calcification at the inferior edge of the lesion

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10. Fig. 9. Optical coherence tomography of the patient N. (35 years old). Circular scan of the peripapillary area. Green arrows – hyperreflective line separating choroidal osteoma from the thinned choroid; orange arrows – zone of impaired Bruch’s membrane visualization; asterix – choroid with a “mesh structure”; red arrows – a zone of the dramatic choroidal thinning. Fundus photo – Fig. 7

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11. Fig. 10. Optical coherence tomography of the left eye of patient G. (22 years old); horizontal scan across the fovea. Arrow – border between choroidal osteoma and normal choroid. Fundus photo – Fig. 6, b

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12. Fig. 11. Optical coherence tomography of the left eye of patient N. (35 years old); horizontal scan across choroidal neovascularization area. Blue asterix – choroid with a “mesh structure”, green arrows – hyperreflective line separating choroidal osteoma from the thinned choroid; red asterix – choroid with “lamellar” structure

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13. Fig. 12. OCT-angiography of the same eye, segmentation on the level of retinal avascular layers. Arrow – choroidal neovascularization area

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14. Fig. 13. Optical coherence tomography of the patient Ch. (21 years old). Vertical scan across choroidal osteoma. Asterix – choroid with “lamellar” structure, arrow – local changes on the retinal pigment epithelium level. Fundus photo – fig. 8

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15. Fig. 14. Fundus photo of patient D. (76 years old). Blue arrows – zone of retinal atrophy, green arrows – astrocytoma

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16. Fig. 15. Optical coherence tomography - horizontal scan across the maximal prominence of retinal astrocytoma. Asterix – a cavity in the center of the focus; red arrows – thickening of the inner layers of the retina along the edges of the focus; green arrows – zone of partial shielding of underlying structures

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Copyright (c) 2019 Stoyukhina A.S.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
 


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