Unilateral Choroidal Osteoma with Choroidal Neovascularization

Case Report

Austin Ophthalmol. 2016; 1(1): 1003.

Unilateral Choroidal Osteoma with Choroidal Neovascularization

Crawford CM¹ and Igboeli OC²*

¹Tufts New England Eye Center, Ophthalmic Consultants of Boston, USA

²Department of Ophthalmology, Carl R Darnall Army Medical Center, USA

*Corresponding author: Okezie C Igboeli, Department of Ophthalmology, Carl R. Darnall Army Medical Center, 36065Santafe Drive, Fort Hood, TX 76544, USA

Received: September 09, 2016; Accepted: October 14, 2016; Published: October 17, 2016

Abstract

Purpose: Choroidal osteoma is a rare tumor which features intraocular bone formation. This tumor can be complicated by choroidal neovascularization which is a cause of impaired vision in this condition. We present a case of choroidal osteoma with choroidal neovascularization as a complication.

Methods: Case report with clinical and angiographic correlation.

Results: A 16 year old female presented with a choroidal osteoma in the left eye complicated by choroidal neovascularization. Intravitreal Anti-Vascular Endothelial Growth Factor (Anti-VEGF) was injected into the left eye. Gradual improvement in vision was noted in the affected eye following the anti-VEGF treatment.

Conclusion: We present a case of choroidal osteoma with choroidal neovascular membranes. Anti-VEGF therapy is employed in the treatment of subfoveal Choroidal Neovascularization (CNV) while photodynamic therapy may be considered for extramacular CNV.

Disclosures: The authors have no financial or proprietary disclosures or conflict of interest with this submission. The views expressed in this submission do not reflect the views, opinions, or policies of the Army or any branch of the Department of Defense.

Keywords: Choroidal osteoma; Choroidal neovascularization; Phthisis bulbi; Anti-Vascular Endothelial Growth Factor

Introduction

Choroidal osteoma is a rare tumor associated with intraocular bone formation. It is often an incidental finding on routine examination but can also present as a cause of decreased vision. We present the case of a young female with a choroidal osteoma as well as brief review of the literature with regards to the evaluation and management of choroidal osteomas.

Case Presentation

A 16 year old female presented to the New England Eye Center with a chief complaint of decreased vision and metamorphopsia in the left eye. The symptoms started three months prior to presentation and were unchanged since they developed. There were no other visual complaints at the time of presentation. She denied any prior ocular history; this was her first eye exam. On review of systems, there was no history of recent or chronic illness such as diabetes mellitus, no steroid use, no recent medication use, no prior eye disease, and no prior history of surgery. The patient also denied any family history of significant vision loss or eye pathology.

Her initial work up began with a comprehensive examination of both eyes. Her visual acuity was 20/20 OD, and 20/25-2 OS. Intraocular pressure was measured as 14 OU. Anterior segment exam was unremarkable in both eyes. In the left eye, Dilated Fundus Examination (DFE) revealed an amelanotic choroidal lesion encompassing the macula with over lying pigment changes at the level of the Retinal Pigmented Epithelium (RPE). Intraretinal Hemorrhage (IRH) and Subretinal Fluid (SRF) were observed in the inferior macula (Figure 1A and Figure 1B).