Senile choroidal sclerosis.

Choroidal sclerosis is a descriptive term applied to the ophthalmoscopic appearance of prominent white choroidal vessels in which the blood columns are not seen or are sheathed by white lines. The two pathological reports of central areolar choroidal atrophy (Ashton, I953; Babel, I958) and one report of central choroidal sclerosis (Howard and Wolf, I964) have not shown a greater degree of angiosclerosis than would be expected for the age of the patients. This discrepancy between the clinical interpretation and the histological findings has caused some observers to favour the term choroidal atrophy as originally applied by Nettleship (I884) and Morton (I885). Recently Krill and Archer (I97i) have supported this concept on the basis of fluorescein studies demonstrating atrophy of one or more layers of the choroidal vessels. Affected areas of the fundus are often limited to well-defined zones in which the choroidal circulation is exposed by atrophy of the overlying tissues, and Sorsby (I939) distinguished central, generalized, and peripapillary varieties. Sorsby further drew attention to hereditary features of the condition and subsequently described the early stages, thereby establishing it as an heredo-degeneration with onset earlier in life. However, the fullydeveloped picture is more commonly encountered in senile eyes. In these cases a similar clinical picture may apparently result from senile arteriosclerosis (Cohen, I938). Because of the lack of pathological material, the nature of the changes in the vessel walls which account for their clinical appearance remains uncertain. This report correlates the clinical and pathological changes in two cases of choroidal sclerosis.