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Choroidal osteoma (CO) is a flat to minimally elevated, yellow-white choroidal lesion frequently located in the juxtapapillary or macular location. ISCC is the abnormal deposition of calcium in the sclera and adjacent choroid in elderly individuals.

The authors present a case of choroidal osteoma diagnosed in a 25-year-old female patient. A well-defined and slightly elevated yellow lesion located in the posterior pole of the right eye was suspected to be a tumor. Confirmation of diagnosis was obtained with A and B ecography. The patient had low vision and macular edema, which improved after intraocular injection of bevacizumab .

Resume Introduction L’osteome choroidien est une tumeur rare, benigne mais qui peut se compliquer de neovascularisation. Patients et methodes Un patient âge de 11 ans s’est presente a la consultation pour flou visuel de l’œil droit. Le fond d’œil a permis de mettre en evidence une volumineuse tumeur choroidienne aux contours geographiques et aux teintes caracteristiques d’un osteome mais de localisation peu habituelle, dans le pole posterieur, maculaire. On notait en son sein la presence d’une hemorragie sous-retinienne. Le patient fut traite par trois injections intravitreennes (IVT) successives sous anesthesie generale de bevacizumab 1,25 mg/0,05 mL en raison de recidives de l’activite neovasculaire. Un examen en SD-OCT et en mode EDI fut realise avant chaque IVT. Resultats Les examens en SD-OCT realises avant et apres l’IVT de bevacizumab ont confirme la regression du DSR de part et d’autre de la lesion et notamment en regard de l’hemorragie. Ils nous ont egalement permis d’individualiser les zones decalcifiees actives des zones calcifiees inactives et d’en suivre l’evolution apres traitement. Discussion Le traitement des neovaisseaux choroidiens (NVC) secondaires a un osteome choroidien n’est pas bien codifie. Comme dans d’autres etiologies, les anti-VEGF (ici le bevacizumab) semblent efficaces pour faire regresser le neovaisseau et ameliorer la fonction visuelle. Chez notre jeune patient, une anesthesie generale a ete necessaire pour realiser chaque IVT. Le SD-OCT permet de confirmer le diagnostic et de suivre l’evolution du NVC. Le mode EDI est ici interessant pour etudier la reflectivite de la choroide. Conclusion Nous presentons un cas rare d’osteome choroidien maculaire, examine en SD-OCT. La survenue de NVC a necessite la realisation de plusieurs IVT d’anti-VEGF, avec un bon resultat anatomique et fonctionnel.

An 18-year-old male was clinically diagnosed as having choroidal osteoma in August 2005. Ocular examination revealed 4 disk diameter orange colored elevated lesion in the left eye. Ultrasonography and computed tomographic (CT) scan of orbit, fluorescein angiogram (FA) and optical coherence tomography (OCT) confirmed the diagnosis of choroidal osteoma. The patient was followed up at regular intervals and on the 4th year followup developed a choroidal neovascular membrane (CNVM) within the osteoma. It was treated with intravitreal bevacizumab. Patient was stable for next 2 years followed by a recurrence of the membrane for which further injections were given to regress it. During this period there was consistent progression of the size of osteoma as well as its decalcified component. We documented progression of the osteoma along with regression of the CNVM with color photo and OCT for 7 years. Spectral domain features of the osteoma were noted in relation to changes occurring in its decalcified area. Long-term follow-up suggests that choroidal osteoma along with the decalcification part within it progresses with time. Intravitreal bevacizumab is effective in treating the CNVM secondary to choroidal osteoma.

Choroidal osteoma is an uncommon benign osseous intraocular tumor that typically affects young adult women. Choroidal neovascularization (CNV) is one of the complications that can develop in eyes with choroidal osteoma. We present a case of CNV secondary to choroidal osteoma treated with intravitreal ranibizumab. A 57-year-old lady presented with painless loss of vision with a right-eye visual acuity of 20/800. Fundus examination showed a well-demarcated yellowish peripapillary choroidal osteoma with associated retinal and subretinal hemorrhage due to CNV. Three intravitreal ranibizumab injections at monthly intervals were given and her visual acuity improved to 20/30 following treatment. After 1.2 years of follow-up, the right eye visual acuity was maintained at 20/30 with no evidence of CNV recurrence. Our findings suggest that intravitreal ranibizumab may be an effective therapeutic option for treating CNV secondary to choroidal osteoma.

Purpose: To describe a case of choroidal osteoma with choroidal neovascularization (CNV) that was successfully treated with two intravitreal injections of bevacizumab (IVB). Design and methods: Case report on a 12-year-old Japanese girl who presented with a sudden decrease in vision in her left eye. At the first visit, 2 days after the onset of her symptoms, her visual acuity (VA) in her left eye was 0.2. Ophthalmoscopy showed a hemorrhage of 5 disc diameters under the retinal pigment epithelium and a serous retinal detachment at the posterior pole of the left eye. These findings were confirmed by optical coherence tomography. Fluorescein angiography (FA) and indocyanine green angiography (ICGA) showed several points of leakage around the fovea, which suggested a CNV. From these findings, the patient was diagnosed with choroidal osteoma with a CNV. The submacular hemorrhage was from the CNV associated with the choroidal osteoma. We treated her with two injections of 1.25 mg/0.05 mL IVB with a 4-month interval. Results: The patient’s VA in her left eye improved to 0.7, and this vision was maintained for 4 years. The CNV disappeared in the FA and ICGA images and no recurrence was observed after 4 years. Conclusion: Our findings indicate that IVB is effective in resolving CNV in eyes with an osteoma and prevents a decrease of vision in eyes with a choroidal osteoma with a CNV.

Twenty-seven years old healthy woman presented with complaints of sudden painless blurred vision in right eye for 1 week. On examination, visual acuity was 20/30 in the right eye and 20/20 in left eye. Fundus examination OS was normal; OD demonstrated a flat, opaque, yellowish parapapillary choroidal lesion with grayish membrane associated with minimal subretinal fluid suggestive of a CNVM in the center. B-scan ultrasonography revealed findings consistent with a choroidal osteoma. Fundus fluorescein angiography of the right eye revealed a relatively well-defined area of hyperfluorescence that increased in size and intensity in the later phases suggestive of active extrafoveal CNVM. Optical coherence tomography confirmed the extrafoveal CNVM with subfoveal fluid. She was treated with intravitreal Bevacizumab OD. At the 2 weeks visit, vision OD improved to 20/20. The FFA and OCT revealed a resolved CNVM. Intravitreal Bevacizumab may be an effective alternative in the management of CNVM secondary to choroidal osteoma.

Choroidal osteoma is a rare benign intraocular tumor composed of calcification throughout the choroid. Various treatment modalities are available according to location of the tumor and the cause of the visual distortion. We report herein a 30-year-old male who was referred to our hospital with acute blurred vision as a result of the subretinal hemorrhage from choroidal osteoma. We ruled out the presence of CNV and observation was preferred and we prevented unnecessary treatment attempts as spontaneous recovery is the easiest and safest way.

A 38-year-old woman presented to outpatient department with the chief complaints of gradual onset of painless diminution of vision in the right eye since last 1 month. At presentation, the visual acuity in OD was perception of light and 20/20 in OS. Slit-lamp examination of anterior segment was found to be within normal limits in both eyes. On fundus evaluation of right eye, exudative retinal detachment1 with shifting fluid along with oedematous disc with blurry margin and juxtapapillary subretinal yellowish brown mass were noticed (figure 1A). Fundus …

The purpose of this study was to evaluate the effect of intravitreal injection of bevacizumab on subretinal fluid associated with choroidal osteoma.In this retrospective noncomparative case series, eyes with serous retinal detachment involving the macula were treated with intravitreal injection of bevacizumab (1.25 mg/0.05 mL) and carefully followed-up with complete ophthalmic examination, including angiography and optical coherence tomography. The changes in best-corrected visual acuity and central foveal thickness were assessed by optical coherence tomography.Six eyes received intravitreal injection of bevacizumab for serous retinal detachment. Only one eye had choroidal neovascularization associated with serous retinal detachment. The mean number of injections for the 6 eyes was 2.0 during the mean follow-up period of 11.3 months. The median logarithm of the minimum angle of resolution best-corrected visual acuity improved from 0.70 (Snellen equivalent, 20/100) at baseline to 0.30 (Snellen equivalent, 20/40; P = 0.043) at the final visit. The optical coherence tomography result also showed a significant reduction in central foveal thickness with a median central foveal thickness of 357.0 microm at baseline and 169.50 microm at the final visit (P = 0.028). The treatment was well tolerated, without ocular or systemic adverse events.Intravitreal injection of bevacizumab for serous retinal detachment secondary to choroidal osteoma resulted in both visual and anatomical improvements.

Three-dimensional optical coherence tomography (OCT) were founded to be useful to evaluate posterior pole involvement in an unusual concurrence of bilateral choroidal osteoma after optic disk inflammation in a 36-year-old woman in whom optic neuritis was the first symptom of Behçet's disease. Bilateral asymmetric choroidal osteoma was observed after optic disk inflammation following disease recurrence. B-scan ultrasonography and orbital axial CT were essential for the diagnosis. Bilateral full-thickness calcified plaques in juxtapapillary choroids were the main intraocular feature after optic neuritis. The pathogenesis of bone formation in choroidal osteoma remains uncertain and although several etiological factors have been associated with its onset, intraocular inflammation is a very unusual cause.

A 17-year female was referred for complaints of blurring and decreased vision in the right eye. The patient underwent fundus examination, optical coherence tomography and B-scan ultrasonography. A well-defined, yellow-orange colored lesion was present in the posterior pole. This lesion created an echodense lesion on B-scan even with low gain. The patient was diagnosed with choroidal neovascularization (CNV) associated with choroidal osteoma. The patient was treated with seven consecutive intravitreal anti-vascular endothelial growth factor (VEGF) injections over 14 months. Intravitreal anti-VEGF was effective for CNV associated with choroidal osteoma. Long- term follow-up is necessary to resolve the fluids, possible development of CNV, and possible of bilateral occurrence.

Purpose A study presents features of choroidal osteoma in Deep Range Imaging Optical Coherent Tomography (DRI-OCT). Methods We analysed 5 cases with choroidal osteoma. All patiens were diagnosed, treated and follow-up at the Ophthalmology and Ocular Oncology Department of University Hospital in Cracow during 2013 and 2015 years. Diagnosis of osteoma was established on basis of typical features found during fundus and ultrasonography examnations. Additionaly, DRI-OCT was performed in all choroidal osteoma cases. Images were evaluated by four experienced physicians in using DRI-OCT in differential diagnosis of intraocular tumors. Results In all cases choroidal osteoma were observed smooth undulating tumor surface, multiple intralesional layers, sponge bone structure, transparency with visibility of sclero-choroidal junction and presence of vessels. Conclusions Choroidal osteoma is a rare, benign tumor presents mainly at posterior pole of eye globe in young woman. Especially it should be distinguish from amelanotic choroidal melanoma or metastatic tumors. In these controversial cases DRI-OCT is very useful due to present very characteristic features of choroidal osteoma in this examination.

Choroidal osteoma is an ossifying tumor that is found predominantly in the peripapillary and macular areas. It typically affects otherwise healthy females. Vision loss may occur secondary to the development of choroidal neovascularization (CNV). Fluorescein angiography (FA) remains the gold standard for diagnosing CNV; however, the use of optical coherence tomography angiography (OCTA) as an adjunct to FA is growing. In this report, a 16-year-old female with a large, unilateral peripapillary choroidal osteoma presented with blurred vision. Exam revealed scattered intraretinal hemorrhage, but FA was unable to detect CNV overlying the tumor. OCTA detected abnormal flow in the outer retina corresponding to a type 2 CNV. Following intravitreal anti-vascular endothelial growth factor therapy, the CNV regressed, the hemorrhage resolved, and there was less fluid. OCTA may be helpful in detecting CNV noninvasively in eyes in which FA is equivocal, such as those with choroidal osteoma. [ Ophthalmic Surg Lasers Imaging Retina . 2016;47:69–72.]

The authors introduce a 42-year-old woman with a choroidal osteoma. After 10 years the patient presented a second choroidal osteoma in the same eye; this osteoma has been growing in the last years. New tests that were unavailable during the first diagnosis were performed such as Fundus Autofluorescence or Enhanced Depth Imaging-Optical Coherence Tomography (EDI-OCT). These tests show characteristics of the tumors and allow us to realize a visual prognosis for the patient.

The authors present enhanced depth imaging optical coherence tomography (EDI OCT) and fundus autofluorescence (FAF) characteristics of a patient with bilateral choroidal osteoma and try to make a correlation between two imaging techniques. Two eyes of a patient with choroidal osteoma underwent complete ophthalmic examination. Enhanced depth imaging optical coherence tomography revealed a cage-like pattern, which corresponded to the calcified region of the tumor. Fundus autofluorescence imaging of the same area showed slight hyperautofluorescence. Three different reflectivity patterns in the decalcified area were defined. In the areas of subretinal fluid, outer segment elongations similar to central serous chorioretinopathy were observed. Hyperautofluorescent spots were evident in fundus autofluorescence in the same area. Calcified and decalcified portions of choroidal osteoma as well as the atrophy of choriocapillaris demonstrated different patterns with enhanced depth imaging and fundus autofluorescence imaging. Both techniques were found to be beneficial in the diagnosis and follow-up of choroidal osteoma.

A 59-year-old Chinese female had been diagnosed with choroidal osteoma of the right eye when she was 36. At that time, the best corrected visual acuity was 6/6 but this decreased to 6/12 due to the rapid growth of choroidal osteoma within 10 months. She returned to our clinic 23 years later due to gradual decreased vision (2/60). Ocular examination disclosed spontaneous decalcification of the tumor leaving an area of depigmentation and atrophy of choriocapillaris in the previous osteoma. Time-domain optical coherence tomography showed marked thinning and absence of the inner segment/outer segment photoreceptor junction with irregular elevated retinal pigment epithelium. To sum up, choroidal osteoma is a benign intraocular tumor that can cause visual acuity loss due to retinal pigment epithelium atrophy and photoreceptor degeneration over the years.

Choroidal osteoma is a benign tumor of the choroid. Herein, we report a rare case of decalcified choroidal osteoma found in the retina. A 27-year-old woman presented with visual loss. Her best-corrected visual acuity was 20/50 OS. Ophthalmoscopy of the left eye revealed a yellow-white calcified region accompanied by a decalcified region of four disc diameters in size. After 6 years, spectral-domain optical coherence tomography showed a tumor projected strongly upwards from the choroid and partially through the retina with serous retinal detachment, with both a lamellar appearance and mound-like area. The calcified region became more contractive than was observed on the first visit. Conversely, the decalcified region was wider than was observed on the first visit. Her best-corrected visual acuity was 20/400 OS. Choroidal osteoma was worsened by progression of decalcification. The decalcified choroidal osteoma resulted in poor visual acuity, and projected strongly upward from the choroid and into the retina.

Purpose. To report a case of atypical dome-shaped choroidal osteoma, which was diagnosed by histopathological finding of surgically extracted tumor. Case Report. A 35-year-old woman presented with visual field abnormality in the left eye (OS). Her best-corrected visual acuity with Landolt ring chart was 1.0 OS. The funduscopic examination revealed a yellowish dome-shaped choroidal tumor located in the temporal side of the macula with exudative retinal detachment. 25-gauge pars plana vitrectomy and the extraction of the tumor were performed for the definitive diagnosis. Results. As a result of histopathological finding from the extracted tumor, she was diagnosed with choroidal osteoma. 10 months after the last surgery, the BCVA is 0.7 OS. The tumor is not relapsed. Conclusions. We must keep in mind that choroidal osteoma can be one of the differential diagnoses for the dome-shaped choroidal tumor.

To report the case of a 52-year-old female with recent complaint of decreased vision associated with a well-defined depigmented lesion in the macula in the right eye. She had a history of surgery for pituitary microadenoma and breast lump excision. Based on spectral-domain optical coherence tomography, fundus fluorescein angiography, indocyanine green angiography, and B-scan ultrasonography, a diagnosis of the right eye choroidal osteoma was made. Subretinal fluid (SRF) was noted in the absence of obvious classic choroidal neovascularization (CNV). The patient was given monthly intravitreal ranibizumab injection over 3 months. Visual acuity was 20/80 preinjection, which dramatically improved to 20/20 after the injections without any additional treatment. We report an interesting case where SRF was noted in the absence of evident CNV and that antivascular endothelial growth factor can be considered as an effective option even in the absence of an evident CNV.

BACKGROUND A choroidal osteoma is a benign osseous tumor typically arising in the juxtapapillary or peripapillary area. The major cause of visual loss is secondary to the development of a subretinal neovascular membrane. The pattern of neovascularization that develops with osteomas has been typically described as classic choroidal neovascularization (CNV). METHODS Interventional case report. RESULTS A case of bilateral polypoidal choroidal neovascularization (PCV) occurring with bilateral choroidal osteomas is described in a 55-year-old Japanese woman. To our knowledge, this variant form of vasogenesis has not previously been described in association with this tumor. Clinical, angiographic, and optical coherence tomographic features are discussed. Subretinal hemorrhage in the left eye from polypoidal neovascularization in the macula was successfully treated with photodynamic therapy. CONCLUSIONS The association between choroidal osteoma and PCV may have a better prognosis than that with classic CNV. Indocyanine green angiography is a useful tool in characterizing the nature of the neovascularization.

PURPOSE To report a case of choroidal osteoma that developed subretinal hemorrhage after photodynamic therapy (PDT). METHODS Interventional case report. RESULTS An 8-year-old boy was brought to our attention because of mild visual loss in his left eye. The visual acuity was 20/25. A subfoveal yellow-orange-colored lesion, measuring 5.0 mm × 4.5 mm in base diameter was detected in the left eye. B-mode ultrasonography showed an acoustically solid 2.0-mm-thick mass with orbital shadowing. Orbital computed tomography confirmed the presence of calcium, and choroidal osteoma was diagnosed. As there was a decrease in the best-corrected visual acuity (20/30) and the lesion showed growth (6.0 mm × 6.0 mm), PDT was performed at 6 months follow-up. The day after PDT, the visual acuity was counting fingers at 1 m and a subretinal hemorrhage over the lesion was detected. Two weeks after PDT, subfoveal hemorrhage dissappeared with some retinal pigment epithelial hyperplasia and visual acuity increased back to 20/30. CONCLUSION Although PDT can induce decalcification in choroidal osteomas, it should not be performed in subfoveal osteomas unless there is evidence to treat the lesion such as the presence of choroidal neovascularization.

PURPOSE: To report the effect of anti-vascular endothelial growth factor (VEGF) therapy for choroidal neovascularization overlying choroidal osteoma. METHOD: In an interventional case report, intravitreal anti-VEGF therapy was used for tumor-related choroidal neovascularization. RESULTS: A 34-year-old woman with bilateral choroidal osteoma had a decrease in visual acuity in the right eye from 20/30 to 20/100. Ophthalmoscopy revealed partially decalcified circumpapillary, macular choroidal osteoma with overlying subretinal hemorrhage and choroidal neovascular membrane. Intravitreal bevacizumab (Avastin; Genentech, Inc., South San Francisco, CA) resulted in membrane regression and visual acuity improvement to 20/50 at 6 weeks. Further therapy with intravitreal ranibizumab (Lucentis; Genentech, Inc.) resolved persistent subretinal fluid, and visual acuity improved to 20/30 at the 6-month follow-up. CONCLUSIONS: Therapy with intravitreal anti-VEGF medications might be an alternative for patients with choroidal neovascularization overlying choroidal osteoma.

To describe enhanced depth imaging optical coherence tomography findings of choroidal osteoma.Retrospective, observational case series of 15 eyes with choroidal osteoma imaged with EDI-OCT.The mean age at presentation was 27 years. There were 10 women and 3 men. The visual acuity ranged from 20/20 to hand motion, with reduced visual acuity secondary to photoreceptor loss in the foveola (n = 5) or subfoveal fluid (n = 1), and additional choroidal neovascular membrane (n = 3). The mean basal tumor diameter was 8.0 mm, and ultrasonographic thickness was 1.5 mm. Using enhanced depth imaging optical coherence tomography, the mean tumor thickness was 589 μm when compared with a matched choroidal region in the unaffected eye of 247 μm (138% increased thickness) (P = 0.009). The tumor surface topography was classified (ultrasonography vs. enhanced depth imaging optical coherence tomography) as flat (87 vs. 13%), dome (13 vs. 40%), or undulating (0 vs. 47%). On enhanced depth imaging optical coherence tomography, unique features included horizontal lamellar lines (presumed bone lamella) (n = 15, 100%) and hyperreflective horizontal lines (presumed cement lines) (n = 8, 53%). Other features included horizontal tubular lamella with optically empty center (presumed Haversian canals or vascular channels) (n = 9, 60%), vertical tubular lamella (presumed Volkmann canals or vascular channels) (n = 2, 13%), and speckled regions (presumed compact or small trabecular bone) (n = 6, 40%). Of the nine eyes with subfoveolar osteoma, the tumor was completely ossified (n = 4), partially deossified (n = 2), or completely deossified (n = 3). Photoreceptor thinning/atrophy was found in all five eyes with deossified osteoma, whereas intact photoreceptor appearance was noted in the four eyes with ossified subfoveal osteoma.Enhanced depth imaging optical coherence tomography reveals characteristic surface topography of choroidal osteoma as dome or undulating (87%) with unique intrinsic features of horizontal lamellar lines (100%), horizontal (60%) or vertical (13%) tubules, and speckled regions (40%). Photoreceptor loss was evident in every case of tumor deossification.

Purpose To find and analyze characteristic features of choroidal tumors and surrounding tissues, retina, choroid and vessels. Methods Patients with choroidal tumors (choroidal nevus, choroidal melanoma, choroidal metastses, choroidal hemangioma, choroidal osteoma and others) diagnosed and treated in Department of Ophthalmology and Ocular Oncology of University Hospital were included. Swept Source OCT (DRI OCT-1) developed by Topcon was used for imaging. Results Deep range imaging DRI-OCT-1 displays detail structures of not only retina but choroid and even sclera. The characteristic features, of intraocular tumors can improve the differential diagnosis and estimation of progression or treatment effects. Conclusion The new diagnostic modality may be useful for the evaluation of abnormalities observed intratumoral and in a border area and can improve diagnostic accuracy.

Enhanced depth imaging as an adjunctive tool in the diagnosis of decalcified choroidal osteoma

To evaluate two patients with choroidal osteoma using multimodal imaging.The clinical findings, ocular ultrasonography (USG),fundus fluorescein angiography (FFA), optical coherence tomography (OCT) and orbital computed tomography (CT) findings of the patients were analyzed

A rare benign tumor, choroidal osteoma with accompanying choroidal neovascularization treated with laser photocoagulation is reported. Limited decalcification was noted at the borders of laser photocoagulation.

Choroidal osteoma is a rare, yellowish-white lesion of the choroid that predominantly affects young women in the second decade of life. Subretinal neovascularization or collection of subretinal fluid may occur in 50 % or more patients in the long run. A 15-year-old girl presented to our practice with bilateral choroidal osteoma associated with advanced bilateral optic atrophy. The underlying cause for optic atrophy is unclear; possible explanations include mechanical pressure effect and ischemic damage.

PURPOSE To report the effect of off-label use of bevacizumab (Avastin) in the treatment of choroidal neovascularization associated with a choroidal osteoma. METHODS Interventional case report examining antivascular endothelial growth factor therapy used for choroidal neovascularization complicating a choroidal osteoma. RESULTS A 24-year-old man with a choroidal osteoma presented with metamorphopsia and decreased vision in his left eye of 20/60. Clinical examination, fluorescein angiography, B-scan ultrasonography, and optical coherence tomography revealed a well-circumscribed macular choroidal osteoma with overlying subretinal hemorrhage and a choroidal neovascular membrane. The patient was treated with a series of 3 intravitreal bevacizumab (Avastin) injections (1.25 mg/0.05 mL) performed at baseline, 1 month, and 2 months. Treatment resulted in resolution of subretinal hemorrhage and fluid with improvement in visual acuity to 20/30 at the 5-month follow-up. CONCLUSION Intravitreal bevacizumab seems to be a promising treatment for choroidal neovascularization (CNV) associated with choroidal osteomas.

PURPOSE. To describe a patient with choroidal neovascular membrane (CNVM) secondary to choroidal osteoma treated successfully with intravitreal bevacizumab. METHODS. Case report. A 25-year-old healthy woman presented with complaints of sudden painless decrease in vision in the left eye (OS) of 1 month duration. On examination, visual acuity was 20/20 in the right eye (OD) and counting fingers at 1.5 meters OS. Slit lamp examination was unremarkable. Fundus examination OD was normal; OS demonstrated a flat, opaque, yellowish parapapillary choroidal lesion with adjacent subfoveal grayish membrane associated with minimal subretinal fluid suggestive of a CNVM. B-scan ultrasonography revealed findings consistent with a choroidal osteoma. Fundus fluorescein angiography (FFA) of the left eye revealed a relatively well-defined area of hyperfluorescence that increased in size and intensity in the later phases suggestive of active subfoveal CNVM. Optical coherence tomography (OCT) confirmed the subfoveal CNVM with altered foveal contour and distortion of foveal architecture. A diagnosis of subfoveal CNVM associated with choroidal osteoma was made. The patient was treated with intravitreal bevacizumab 1.25 mg in 0.05 mL OS and repeated 6 weeks later. R ESULTS. At the 4-month visit, vision OS improved to 20/125. The FFA and OCT revealed a resolved CNVM. CONCLUSIONS. Intravitreal bevacizumab may be an effective alternative in the management of CNVM secondary to choroidal osteoma. Larger series of such cases need to be studied to further validate our findings. (Eur J Ophthalmol 2008; 18: 466-8)

Transpupillary thermotherapy for subfoveal choroidal neovascular membrane in choroidal osteoma

Os autores apresentam um caso de osteoma de coróide diagnosticado em paciente do sexo masculino aos 62 anos de idade. A lesão bem delimitada e pouco elevada no pólo posterior do olho direito acompanhada de vascularização interna e neovascularização de coróide em sua borda temporal superior e inferior levaram à suspeita do tumor. O diagnóstico de certeza foi obtido com ecografia A e B e tomografia computadorizada. A tomografia de coerência óptica mostrou alta refletividade em toda a espessura do osteoma bem como elevação do complexo EPR-cório-capilar na região da membrana neovascular subretiniana. Embora os achados tomográficos descritos na literatura e os observados neste caso sejam variados, a tomografia de coerência óptica pode colaborar no diagnóstico de osteoma de coróide.The authors present a case of choroidal osteoma diagnosed in a 62-year-old male patient. A well-defined and slightly elevated lesion located in the posterior pole of the right eye associated with internal vasculature and choroidal neovascularization at its superior and inferior temporal edge were suspicious of the tumor. Confirmation of diagnosis was obtained with A and B ecography and computed tomography. Optical coherence tomography showed high reflectivity through its thickness as well as elevation of the RPE-choriocapillaris complex at the choroidal neovascularization site. Although the literature and the present case show several different tomographical findings, optical coherence tomography can help establishing the diagnosis of choroidal osteoma.

The authors report the use of an anti-VEGF agent in the resolution of subretinal fluid and hemorrhage with improvement in best corrected visual acuity (BCVA) in a patient with choroidal osteoma. The reported case involves a 20-year-old man who presented with a choroidal osteoma and chronic subretinal fluid associated with hemorrhage. He was treated with six intravitreal doses of bevacizumab over a 13-month period. The fluid resolved and his BCVA improved with these treatments. Intravitreal bevacizumab can be used to successfully treat subretinal fluid associated with choroidal osteomas and may lead to an improvement in BCVA. [ Ophthalmic Surg Lasers Imaging Retina . 2014;45:169–171.]

TD is a 28-year-old woman who presented to her ophthalmologist with the complaint of distortion of the vision in her left eye over several months. Examination found visual acuity in the right eye of 20/20 and in the left of 20/50. Fundus examination demonstrated a reddish-orange lesion just above the macula with sharply defined borders. Fluorescein angiography revealed diffuse leakage from the tumor and an area of subretinal neovascularization at the temporal border.

Background: To describe the clinical characteristics of two sets of sisters in two families with bilateral choroidal. Methods: The ocular clinical examinations of all the families were performed. Results: (1) Thirteen immediate family members from three generations were included and screened in two families. Bilateral choroidal osteoma was found in two sets of two sisters in the second generation of both families. (2) All of the four patients were young women aged 22 years, 26 years, 26 years and 30 years respectively. (3) Choroidal osteoma lesions located at the posterior to the optic disc and showed a relatively large area. Fundus findings, fluorescein angiography and computed tomography scan results showed typical characteristics of choroidal osteoma. Conclusions: This is the first report of such cases in China. The clinical characteristics of bilateral choroidal osteoma are a larger lesion around the optic disc and early onset. Eyesight of the patient is damaged with the time lapse.

Choroidal neovascularization secondary to choroidal osteoma: successful treatment with photodynamic therapy

Choroidal osteomas are benign osseous tumors of the choroid. These tumors typically occur unilaterally in the juxtapapillary region in young, healthy, white females. The fundus appearance is a yellow-white or orange-red elevated lesion with sharply demarcated irregular borders. Potential complications include growth and visual compromise secondary to choroidal neovascularization. Management involves photodocumentation with annual funduscopic examination and daily Amsler Grid self assessment. Laser photocoagulation is advocated in the presence of choroidal neovascularization within the arcades. A 70-year-old male presented with a unilateral subretinal elevated yellow-orange mass. Although atypical in presentation, the lesion was diagnosed as a choroidal osteoma based on the funduscopic appearance, computed tomography, ultrasonography and serologic testing.