Aflibercept as a treatment for neovascular membrane associated with choroidal osteoma

Abstract

Purpose: To assess the importance of treating the patient with choroidal osteoma‐associated neovascular membrane by administering anti‐angiogenic (anti‐VEGF) drugs. Methods:: We present a descriptive study (case report). We have performed a multimodal imaging study of a patient with an inferior temporal peripapillary choroidal osteoma. The best corrected visual acuity (BCVA) was taken in a patient diagnosed with a choroidal osteoma after magnetic resonance imaging (MRI) and ultrasound. The patient presented with a decrease in visual acuity and a study using optical coherence tomography angiography (OCTA) revealed a type II neovascular membrane affecting the temporal area of the choroidal osteoma. Optical coherence tomography (OCT) revealed a neurosensory detachment. Results: Serial OCT evaluation revealed a neovascular membrane with associated neurosensory detachment, which was treated with intravitreal injections of Aflibercept, resulting in an MAVC of 0.1 to an MAVC of 0.7 after 2 months. On OCTA we observed disruption of the retinal pigment epithelium. Treatment with monthly injections is required for the first 3 months, with bimonthly treatment for a further 6 months. At present the MAVC is 0.6 and no further injections are required for the time being. Conclusions: Serial multimodality imaging is very useful in the follow‐up of patients with choroidal tumours. It allows us to observe associated complications such as the neovascular membrane that we found in the context of a patient with a choroidal osteoma, a benign bone tumour that mainly affects young women without associated diseases. Despite being benign, it can cause irreversible loss of vision either due to the tumour affecting the macular area or due to complications such as choroidal neovascularisation, which occurs in one third of cases.