Calcification at the Margins of a Scleral Defect in Peripapillary Staphyloma

Dear Editor,

We read with great interest the recently published article entitled “Misdiagnosis of peripapillary staphyloma as retrobulbar tumor: a case report,”¹ written by our colleagues, Dr. Du and his associates. They made efforts to avoid unnecessary orbital surgery for a child through comprehensive pre-operative examination. We believe that it has been beneficial to share their experience with other doctors, in order to avoid the same mistake.

In their case report, they provided high quality images of a peripapillary staphyloma. We find an interesting phenomenon that the axial view of orbital computed tomography shows tiny flecks of calcification at the margin of the scleral defect (top left of Fig. 1 in their article), but not in the sagittal view (top right of Fig. 1). We are interested in whether the calcification at the margin of the scleral defect in peripapillary staphyloma only appears nasally and temporally, but not superiorly and inferiorly:

Rui-Wu Zhou

Department of Ophthalmology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, P. R. China

Xiao-Dong Chen

Department of Anesthesiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, P. R. China

Author’s Reply

Dear Editor,

We thank Drs Zhou and Chen for their interest in our article.¹ We have reviewed the orbital computed tomography (CT) images of the patient with peripapillary staphyloma, including all the levels of axial and sagittal views. No obvious calcification was found at the superior and inferior margin of the excavation. To the best of our knowledge, no other sagittal CT image of peripapillary staphyloma or morning glory syndrome has been published. Hence, we cannot confirm whether it is a ubiquitous phenomenon that calcifications only appear at the nasal and temporal margin of the excavation in the congenital condition.

Y Du, CX Zhou, JF He, SQ Lu and YC Lin.