133. Peripheral White Lesion
This is a white lesion just outside of the vascular arcade. What is it?
Analysis
While the retinal tissue is normal to the right and left, the lesion is noted to be elevated (as opposed to a depression or absence of tissue which can also present as a depigmented lesion). The retinal tissue overlying the lesion is normal, with the exception of some compression of the outer nuclear layer. The external limiting membrane (ELM) and underlying ellipsoid are visible in the area to the right. There is elevation of the RPE from the underlying Bruch’s membrane (A is showing Bruch’s membrane). The hyperreflective area in the retina is normal and is related to a retinal blood vessel that has been sectioned. The lesion, itself, is located at the level of the sclera and is hyperreflective.
The patient was diagnosed with a sclerochoroidal calcification (SCC).
Did you know that this lesion has been linked to serious systemic disease (and potentially life-threatening disease)? In this tip's accompanying 18 min. video, Dr. Sharma takes you through additional diagnostic imagery as well as:
- Learn the differential diagnosis of an elevated white lesion
- Review the OCT in the context of the clinical photograph, and additional testing
- Learn how a patient with a sclerochordoial calcification needs to be worked up to rule out serious (and potentially life-threatening disease)
OCT Tip
A granuloma may present as an elevated choroidal lesion.
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