Bilateral ocular calcification

This young patient had incidental posterior globe calcification noted. It most likely relates to intrauterine or early infancy chorioretinitis.
Numerous causes of calcification of the globe are encountered, varying from the benign to malignant. When calcification is seen in the posterior half of the globe, it could relate to any of the layers (scleral, choroidal or retinal), as it is not possible to separate them out on CT.
Retinal: drusen - 1% population at optic disc. Benign; retinoblastoma; retinocytoma; tuberous sclerosis - “giant drusen” - astrocytic hamartomas; epiretinal membranes; Coat’s disease.
Retinochoroidal: chorioretinitis - most commonly following Toxoplasmosis.
Choroidal: choroidal osteomas - more common in patients with tuberous sclerosis; choroidal angiomas - occasionally calcify.
Sclerochoroidal: metastatic calcification - abnormal calcium and phosphate metabolism; dystrophic calcification - abnormal tissues become calcified, despite normal Ca and P metabolism, seen occasionally in elderly caucasians, most frequently men.
Phthisis bulbi - is the end result of major injury to the eye (trauma, infection) with a shrunken calcified ‘lump’ remaining.
References:
M Castillo “Neuroradiology companion: Methods, Guidlines, and Imaging Fundamentals”
N Surendrababu “Globe calcification in congenital tosoplasmosis” Indian Journal of Paediatrics, Vol 73 - June 2006
Credit: Dr Frank Gaillard
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