Intraocular Tumors |
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Fig. 20. Sclerochoroidal calcification. Fundus photograph (A). Transverse B-scan demonstrating an irregularly shaped, highly reflective fundus lesion with orbital shadowing (B).
Astrocytic Hamartoma
Astrocytic hamartoma of the retina and optic disc is a benign tumor that typically occurs in patients who have tuberous sclerosis and neurofibromatosis. Small, noncalcified tumors can be extremely subtle and appear as ill-defined translucent thickening of the nerve fiber layer. Larger lesions become more opaque and appear as a sessile white lesion at the level of the nerve fiber layer. Some lesions contain characteristic dense yellow, refractile calcification that has been likened to mulberry or tapioca. Ultrasonography is of little diagnostic value in small, flat, noncalcified lesions. Larger calcified lesions, however, appear as welldemarcated oval masses with a high reflectivity, sharp anterior borders, and orbital shadowing on B-scan. A scan shows high internal reflectivity and attenuation of orbital echoes posterior to the tumor (Fig. 18).
Choroidal Osteoma
Choroidal osteomas are composed of cancellous bone and present as yellow-white, minimally elevated, well-defined lesions in the juxtapapillary or peripapillary region. These lesions produce extremely high internal reflectivity on A-scan. They are very echo-dense on B-scan with significant orbital shadowing (Fig. 19).
Sclerochoroidal Calcification
Sclerochoroidal calcification simulates choroidal osteoma ultrasonographically with high reflectivity and marked orbital shadowing. Distinction between these two entities is based on clinical features (Fig. 20).
Others
Cogan’s plaques are focal areas of scleral calcification located anterior to the insertion of the horizontal rectii muscles. Chronic ocular inflammation or trauma can induce osseous metaplasia of the RPE with or without phthisis bulbi, which can be detected as intraocular calcification by ultrasonography.
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