Complications, treatments, and visual prognosis of choroidal osteomas

Abstract

Purpose This study aims to report complications, treatments, and visual prognosis of choroidal osteoma. Methods We retrospectively reviewed electronic medical records and multimodal images of 41 patients with choroidal osteoma. Results Visually significant complications included choroidal neovascularization (CNV) in 21 (47.7%) eyes and subretinal fluid (SRF) without CNV in 14 (31.8%) eyes. The most common treatment was intravitreal anti-vascular endothelial growth factor (VEGF) injection: 13 (61.9%) eyes with CNV received an average of 6.3 injections, and 6 (42.9%) eyes with SRF but without CNV received 1.8 injections. As the first-line treatment, intravitreal anti-VEGF injection induced complete or partial remission in 93.4% of eyes with CNV and 57.1% of eyes with SRF. The probability of legally low vision estimated at 3 and at 5 years was 29.1% and 34.2%, respectively. The presence of CNV and outer retinal tubulation (ORT) was independent risk factors for vision loss (adjusted odds ratio, 8.08 and 6.94, respectively). Conclusions The development of CNV and ORT was strong risk factors for visual impairment. Due to the frequent recurrence of complications and poor visual prognosis, regular check-ups and appropriate treatment choices are warranted.

Bilateral Choroidal Osteomas in an Elderly Woman: A Case Report

“…However, the authors inserted a proviso at the end of the case report that treatment of subfoveal CNV with photodynamic therapy might result in worse visual acuity due to decalcification and associated RPE loss. More recently, anti-vascular endothelial growth factor drugs have been used off-license to treat CNV secondary to choroidal osteoma with good effect [ 9 ].…”

“…Most of the time, patients present with a decreased vision when significant atrophy of retinal layers has already occurred. The correct management involves observation in asymptomatic cases with fundus examination and multimodal imaging at regular intervals, to detect the development of CNV or atrophy of retinal layers, so that loss of vision can be minimized [ 9 ].…”

Choroidal Osteoma With Choroidal Excavation Due to Decalcification Five Years After Photodynamic Therapy: A Case Report

“…However, COs are progressive and a prolonged disease progression has been associated with a reduction in vision [ 4 , 5 ]. Subretinal fluid (SRF) without choroidal neovascularization (CNV) and CNV have been reported to be the cause of vision reduction [ 6 , 7 ]. The location of the CO affects the visual prognosis.…”

Spontaneous Resolution of Subretinal Detachment in Choroidal Osteoma Unresponsive to Antivascular Endothelial Growth Factor Agent and Multimodal Imaging: A Case Report

“…Song et al [ 3 ] reported that four out of five patients achieved complete resolution of SRD in response to anti-VEGF treatment, while one achieved only partial resolution of SRD after five months of treatment. Seong et al [ 5 ] has shown that SRD without CNV responded worse to anti-VEGF treatment than did SRF with CNV. However, anti-VEGF was effective in about half of cases with SRF without CNV for the reason not clear at the moment [ 5 ].…”

“…Seong et al [ 5 ] has shown that SRD without CNV responded worse to anti-VEGF treatment than did SRF with CNV. However, anti-VEGF was effective in about half of cases with SRF without CNV for the reason not clear at the moment [ 5 ]. In the present case, the SRD did not respond to anti-VEGF therapy.…”