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Zhang L, Ran QB, Lei CY, Zhang MX. Clinical features and therapeutic management of choroidal osteoma: A systematic review. Surv Ophthalmol 2023; 68:1084-1092. [PMID: 37321477 DOI: 10.1016/j.survophthal.2023.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 06/06/2023] [Accepted: 06/06/2023] [Indexed: 06/17/2023]
Abstract
Choroidal osteoma is a benign ossifying tumor within the choroid. Complications associated with choroidal osteoma, including disruption of retinal pigment epithelium, atrophy of photoreceptors, subretinal fluid, and choroidal neovascularization, present challenges for clinicians, and management remain controversial. We performed a comprehensive search in the PubMed, EMBASE, and Ovid databases for published studies and case reports relating to the management of choroidal osteoma. Since it was first described in 1978, various case reports of ocular complications associated with choroidal osteoma have been documented, and various therapies have yielded different outcomes. We systematically evaluate the literature published on this rare entity.
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Affiliation(s)
- Li Zhang
- Sichuan University West China Hospital, Chengdu, China.
| | - Qi-Bo Ran
- Sichuan University West China Hospital, Chengdu, China.
| | - Chun-Yan Lei
- Sichuan University West China Hospital, Chengdu, China.
| | - Mei-Xia Zhang
- Sichuan University West China Hospital, Chengdu, China.
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Clinical Observation of Choroidal Osteoma Using Swept-Source Optical Coherence Tomography and Optical Coherence Tomography Angiography. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12094472] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Choroidal neovascularization (CNV) secondary to choroidal osteoma (CO) can cause profound visual loss, but detecting CNV and the tumor’s feeder vessels using traditional fluorescent angiography imaging is challenging. Newly developed TowardPi swept-source optical coherence tomography (SS-OCT) and OCT angiography (SS-OCTA) enable ultra-high resolution, enhanced penetration with longer wavelength (1060 nm), a rapid scan rate (400 KHz), reduced loss of signal strength with increasing depth, and 120° angular widefield of fundus view, enabling a nearly histological description of the retina and choroid. We therefore used this SS-OCT and SS-OCTA platform to observe the intrinsic features of osteoma in 23 eyes of 21 patients. It was found that the borders of CO were clearly demarcated from the adjacent choroidal Sattler’s and Haller’s layers, while on a corresponding B-scan the blood flow of the CO was detected mainly within the choriocapillaries and partly within Sattler’s layer. The CNV was identified as numerous branching or radiating vessels connecting with intrinsic feeder vessels displaying various patterns including ginseng, instant noodle, growth ring, tangle, spider web, medusa, seafan, and irregular shape. Moreover, tumor-like tissues were found to grow above the disrupted Bruch’s membrane. SS-OCTA can be used to detect the tumor vasculature in CO.
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Verma A, Maitra P. Spontaneous Regression of Asymptomatic Bilateral Choroidal Osteoma with Preserved Vision. Ophthalmic Surg Lasers Imaging Retina 2021; 52:519. [PMID: 34505808 DOI: 10.3928/23258160-20210825-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
[Ophthalmic Surg Lasers Imaging Retina. 2021;52:519.].
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Zhang Y, Fang J, Zhao S, She X, Wang J, Shen L. Secondary choroidal neovascularization due to choroidal osteoma after 9 years follow-up. BMC Ophthalmol 2021; 21:242. [PMID: 34058993 PMCID: PMC8167975 DOI: 10.1186/s12886-021-02004-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 05/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Choroidal osteoma is a benign intraocular tumor that can increase risk of developing choroidal neovascularization. The visual prognosis is influenced by the tumor location, decalcification status, overlying RPE atrophy, presence of choroidal neovascularization, persistence of subretinal fluid and occurrence of subretinal hemorrhages. CASE PRESENTATION The authors present a 40-year-old woman diagnosed with choroidal osteoma of the right eye. Her best corrected visual acuity was 12/20 but decreased to 5/20 due to secondary choroidal neovascularization after 8 years follow up. Fundus examination revealed an enlarged choroidal osteoma in most margins at posterior pole with schistose hemorrhage beside macula. Optical coherence tomography angiography revealed unique features in the vascular changes of choroidal neovascularization in choroidal osteoma in the outer retinal layer and choroid capillary layers, and subretinal neovascularization. Indocyanine green fluorescence angiography showed there was hypo-fluorescence at the peripapillary with faint hyper-fluorescence at the macular, corresponding to the location on the fundus photograph. The patient received 3 injections of intravitreal ranibizumab. After 1 year follow up, her visual acuity of the right eye was 18/20 and the CNV had regressed. CONCLUSIONS We present the findings and treatment of a case of choroidal osteoma with secondary choroidal neovascularization. Optical coherence tomography angiography combined with FFA and ICGA is used to analysis the characteristics of secondary choroidal neovascularization. Optical coherence tomography angiography can reveal some unique characteristics in the vascular changes compared to fundus fluorescein angiography.
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Affiliation(s)
- Yun Zhang
- Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, Zhejiang, China
| | - Jia Fang
- Yongkang First People's Hospital of Hangzhou Medical College, Jinhua, Zhejiang, China
| | - Shixin Zhao
- Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, Zhejiang, China
| | - Xiangjun She
- Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, Zhejiang, China
| | - Jun Wang
- Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, Zhejiang, China
| | - Lijun Shen
- Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, Zhejiang, China.
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Chehab HE, Dot C, Mathis T, Agard E, Kodjikian L. Contribution of swept-source OCT-angiography in analysis of choroidal osteoma and its quiescent neovascular complications: A case study. Am J Ophthalmol Case Rep 2020; 19:100769. [PMID: 32551403 PMCID: PMC7287234 DOI: 10.1016/j.ajoc.2020.100769] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 03/17/2020] [Accepted: 06/01/2020] [Indexed: 11/26/2022] Open
Abstract
Purpose Choroidal osteoma (CO) is a rare benign tumor of the choroid. Improvements in Optical Coherence Tomography (OCT) technologies, notably swept-source (SS), enables a better visualization of the choroid with deeper signal penetration in the tissues. Observation We describe SS-OCT and OCT-angiography findings in a 30-year-old patient with CO. The best visualization of the choroid allows even more precise analysis beyond the identification of classical structures of trabecular bone and denser cortical bone. OCT-Angiography show in this case a quiescent choroidal neovascularization without exudation on B-scan OCT. Conclusions and importance SS-OCT and OCT-angiography allow a nearly histological description of choroidal osteoma. Patient consent Written consent to publish this case has not been obtained. This report does not contain any personal identifying information.
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Affiliation(s)
- Hussam El Chehab
- Ophthalmology Department, Military Hospital of Desgenettes, Lyon, France
- Corresponding author. Ophthalmology Department, Military Hospital of Desgenettes, 108, Bd Pinel, 69003, Lyon, France.
| | - Corinne Dot
- Ophthalmology Department, Military Hospital of Desgenettes, Lyon, France
- French Military Health Service Academy, Val de Grâce, Paris, France
| | - Thibaud Mathis
- Ophthalmology Department, Croix-Rousse Teaching Hospital, Lyon, France
| | - Emilie Agard
- Ophthalmology Department, Military Hospital of Desgenettes, Lyon, France
| | - Laurent Kodjikian
- Ophthalmology Department, Croix-Rousse Teaching Hospital, Lyon, France
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Huang YM, Zhang L, Liang J, Yuan RD. Bilateral choroidal osteoma with unilateral polypoidal choroidal vasculopathy treated with conbercept. Int J Ophthalmol 2020; 13:1009-1012. [PMID: 32566516 DOI: 10.18240/ijo.2020.06.23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 02/12/2020] [Indexed: 11/23/2022] Open
Affiliation(s)
- Yan-Ming Huang
- Xinqiao Hospital of Army Medical University, Chongqing 400038, China
| | - Li Zhang
- Xinqiao Hospital of Army Medical University, Chongqing 400038, China
| | - Jin Liang
- Xinqiao Hospital of Army Medical University, Chongqing 400038, China
| | - Rong-Di Yuan
- Xinqiao Hospital of Army Medical University, Chongqing 400038, China
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Azad SV, Kumar V, Chawla R, Kashyap B, Temkar S, Kumar A, Venkatesh P, Vohra R, Molla K, Sharma A. In vivo optical biopsy of choroidal osteoma: a swept source optical coherence tomography-based tumor characterization. Ther Adv Ophthalmol 2020; 12:2515841420922740. [PMID: 32518894 PMCID: PMC7252358 DOI: 10.1177/2515841420922740] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 03/02/2020] [Indexed: 11/26/2022] Open
Abstract
Objective: To study tumor characteristics of choroidal osteoma by swept source optical coherence tomography. Methods: A retrospective case series done at tertiary referral center in northern India. All patients diagnosed with choroidal osteoma examined on swept source optical coherence tomography were included. Swept source optical coherence tomography images were analyzed for integrity of retinal layers—intraretinal layers, outer retinal layers (photoreceptor), retinal pigment epithelium, and contour abnormalities. Choroidal changes assessed were tumor attributes such as shape, depth of choroidal involvement, tumor mass reflectivity pattern, tumor vascularity, and evolutionary structural abnormalities such as deossification, focal depressions, or choroidal neovascular membrane. Results: A total of 15 eyes of 11 patients were analyzed. Seven of 11 patients were females. Mean age of presentation was approximately 26 years. Tumor was large in nine cases (>7.5 mm). Deossification was seen in 12 eyes. Inner and outer retinal integrity was maintained in 7 and 2 eyes, respectively. Most common internal tumor reflectivity pattern seen was a lamellar appearance (12/15). Increased signal transmission to choroid and focal area of deep excavation was present in 11 and 4 eyes, respectively. Osteoclastic activity was noted in 12 eyes. Choroidal neovascular membrane was seen in 6 eyes. Small lesions showed lamellar pattern of tumor reflectivity with preservation of retinal pigment epithelium and overlying retina. Larger tumors were deossified with 6 irregular tumor contour, disorganization of the outer retina, increased signal transmission to choroid, and areas of osteoclastic activity. Conclusion: Swept source optical coherence tomography was helpful in assessing tumor attributes and predicting the different timelines in tumor evolution.
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Affiliation(s)
| | - Vinod Kumar
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Rohan Chawla
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi 110029, India
| | - Bibhuti Kashyap
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Shreyas Temkar
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Atul Kumar
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Pradeep Venkatesh
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Rajpal Vohra
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Kabiruddin Molla
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Anu Sharma
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
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Narang S, Sindhu M, Sheoran K, Kaur R. Choroidal osteoma: the varied response of subretinal fluid to anti-VEGF agents. BMJ Case Rep 2020; 13:13/5/e234357. [PMID: 32398249 DOI: 10.1136/bcr-2020-234357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The present case shows a remarkable long-term response of the choroidal neovascular membrane and serous retinal detachment associated with choroidal osteoma to two injections of ranibizumab which is an anti-vascular endothelial growth factor (anti-VEGF) agent.
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Affiliation(s)
- Subina Narang
- Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India
| | - Meenakshi Sindhu
- Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India
| | - Khushboo Sheoran
- Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India
| | - Ravinder Kaur
- Department of Radiodiagnosis, Government Medical College and Hospital, Chandigarh, India
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Kim D, Ryu G, Sagong M. Polypoidal choroidal vasculopathy as a complication of choroidal osteoma: A case report. Medicine (Baltimore) 2020; 99:e19927. [PMID: 32443292 PMCID: PMC7253871 DOI: 10.1097/md.0000000000019927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Choroidal osteoma (CO) is a rare benign tumor that particularly affects young, healthy women. Its prognosis is influenced by complications, such as choroidal neovascularization (CNV), subretinal hemorrhage, subretinal fluid (SF), decalcification status, and overlying retinal pigment epithelium (RPE) atrophy. In case of CNV as the complication of CO, it is typically present in the classic form; however, reports on polypoidal choroidal vasculopathy (PCV) have been rare. Here, we report a case of an older, male patient with PCV as a complication of CO. PATIENT CONCERNS A 70-year-old male patient visited the hospital with vision impairment in the right eye since 2 weeks. DIAGNOSIS Fundus examination revealed a red-yellow, well-demarcated, scalloped lesion around the optic nerve in each eye; the lesions were highly reflective on ultrasound examination, and thus, CO was diagnosed. Indocyanine green fluorescence angiography and optical coherence tomography (OCT) revealed that the right eye also had PCV accompanied with SF. OCT confirmed the presence of large quiescent type 1 CNV bilaterally in decalcified areas of the lesions adjacent to the optic nerve. INTERVENTIONS Intravitreal bevacizumab (IB) injection was performed. OUTCOMES Best-corrected visual acuity had improved and OCT showed a decrease in the SF, while OCT angiography showed partial regression of branching vascular network. CONCLUSION CO can be accompanied by quiescent type 1 CNV; this should be closely monitored because it can progress to PCV. Optical coherence tomography, alongside indocyanine green fluorescence angiography, is useful for the diagnosis and monitoring of potential CNV as a complication of CO.
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Agrawal MS, Kumar M, Konana VK, Gudimetla J, Kanakamedla A, Bagad PA. Doughnut osteoma: A rare case of circumpapillary choroidal osteoma. Indian J Ophthalmol 2019; 67:2063. [PMID: 31755459 PMCID: PMC6896537 DOI: 10.4103/ijo.ijo_454_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Manit Sanjay Agrawal
- Department of Ophthalmology, Sankara Eye Hospital, Guntur, Andhra Pradesh, India
| | - Madhu Kumar
- Department of Ophthalmology, Sankara Eye Hospital, Guntur, Andhra Pradesh, India
| | - Vinaya Kumar Konana
- Department of Ophthalmology, Sankara Eye Hospital, Guntur, Andhra Pradesh, India
| | | | - Ashok Kanakamedla
- Department of Ophthalmology, Sankara Eye Hospital, Guntur, Andhra Pradesh, India
| | - Parag Anil Bagad
- Department of Ophthalmology, Sankara Eye Hospital, Guntur, Andhra Pradesh, India
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Balsnæs P, Szabo D, Takacs A, Papp A, Nagy ZZ, Schneider M. Enhanced depth imaging and swept-source optical coherence tomography findings in choroidal osteoma: a case report. SPEKTRUM DER AUGENHEILKUNDE 2019. [DOI: 10.1007/s00717-019-0427-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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12
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Leung EH, Stout JT. I Went in for a Routine Eye Examination. J Pediatr Ophthalmol Strabismus 2018; 55:352. [PMID: 30452763 DOI: 10.3928/01913913-20181018-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Furino C, Di Antonio L, Grassi MO, Rispoli M, Reibaldi M, Niro A, Alessio G. Choroidal neovascularization due to choroidal osteoma treated with anti-vascular endothelial growth factor therapy: An optical coherence tomography angiography study. Eur J Ophthalmol 2018; 29:323-329. [PMID: 30101614 DOI: 10.1177/1120672118792187] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To evaluate the response to anti-vascular endothelial growth factor therapy for choroidal neovascularization secondary to choroidal osteoma using optical coherence tomography angiography. METHODS This retrospective study included four eyes of four females with choroidal osteoma complicated by choroidal neovascularization, treated with ranibizumab. All patients underwent full ophthalmologic examination, including ocular ultrasound, retinography, fluorescein angiography, spectral-domain or swept-source optical coherence tomography, and optical coherence tomography angiography. These images were analyzed to measure choroidal osteoma and to study choroidal neovascularization changes after intravitreal anti-vascular endothelial growth factor. RESULTS In all cases, fluorescein angiography revealed the presence the choroidal neovascularization, as an early hyperfluorescence area increasing during the exam. Optical coherence tomography showed both the choroidal osteoma and choroidal neovascularization and intra- or subretinal fluid as activity sign. In optical coherence tomography angiography, choroidal osteoma vessels were valuable in outer retina and choroidal slabs, and were irregular and did not change after ranibizumab injection; neovascular network correlating with choroidal neovascularization showed a hyperflow tangled vessels in outer retina, decreasing in density after anti-vascular endothelial growth factor therapy. CONCLUSION Optical coherence tomography angiography seems to be a useful tool in visualizing and distinguishing vascular networks of choroidal osteoma and of choroidal neovascularization secondary to choroidal osteoma better than fluorescein angiography.
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Affiliation(s)
- Claudio Furino
- 1 Eye Clinic, Department of Ophthalmology, University of Bari, Bari, Italy
| | - Luca Di Antonio
- 2 Ophthalmology Clinic, Department of Medicine and Science of Ageing, Università degli studi G.D'Annunzio Chieti Pescara, Chieti, Italy
| | - Maria Oliva Grassi
- 1 Eye Clinic, Department of Ophthalmology, University of Bari, Bari, Italy
| | | | - Michele Reibaldi
- 4 Department of Ophthalmology, University of Catania, Catania, Italy
| | - Alfredo Niro
- 1 Eye Clinic, Department of Ophthalmology, University of Bari, Bari, Italy
| | - Giovanni Alessio
- 1 Eye Clinic, Department of Ophthalmology, University of Bari, Bari, Italy
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Chawla R, Azad SV, Takkar B, Sharma A, Kashyap B. Nonconforming Deep Focal Choroidal Excavation in a Patient With Choroidal Osteoma: A Diagnostic Dilemma. Ophthalmic Surg Lasers Imaging Retina 2017; 48:944-947. [PMID: 29121366 DOI: 10.3928/23258160-20171030-12] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 06/15/2017] [Indexed: 11/20/2022]
Abstract
Evolution of an osteoma may result in neurosensory detachment, deossification, and choroidal neovascularization (CNV). The authors report a rare case of choroidal osteoma with CNV associated with a deep non-conforming focal choroidal excavation. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:944-947.].
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Choroidal osteoma. OPHTHALMOLOGY JOURNAL 2016. [DOI: 10.17816/ov9377-81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
This study describes the clinical features, methods of diagnosis, and treatment of a rare intraocular tumor, choroidal osteoma, based on our observation of three patients and a literature review.
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Bilateral Multifocal Choroidal Osteoma with Choroidal Neovascularization. Case Rep Ophthalmol Med 2016; 2015:346415. [PMID: 26770855 PMCID: PMC4684841 DOI: 10.1155/2015/346415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Revised: 11/12/2015] [Accepted: 11/24/2015] [Indexed: 11/30/2022] Open
Abstract
Choroidal osteoma has been reported to be unilateral in approximately 80% of cases diagnosed with this condition. Herein we report the clinical characteristics and multimodal imaging findings in a rare case of bilateral multifocal choroidal osteoma. A 32-year-old female presented with decreased visual acuity (VA) in the right eye (20/100), though she had normal VA (20/20) in the left eye. Ophthalmoscopy and multimodal imaging investigation revealed bilateral multifocal choroidal osteoma complicated by choroidal neovascularization (CNV) in the right eye. Following three injections of intravitreal bevacizumab (IVB) for CNV in the right eye, VA improved to 20/40.
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Szelog JT, Bonini Filho MA, Lally DR, de Carlo TE, Duker JS. Optical Coherence Tomography Angiography for Detecting Choroidal Neovascularization Secondary to Choroidal Osteoma. Ophthalmic Surg Lasers Imaging Retina 2016; 47:69-72. [DOI: 10.3928/23258160-20151214-10] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 10/19/2015] [Indexed: 11/20/2022]
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A Second New Choroidal Osteoma in the Same Eye: Differences between Them with New Imaging Techniques. Case Rep Ophthalmol Med 2015; 2015:684956. [PMID: 25861497 PMCID: PMC4377352 DOI: 10.1155/2015/684956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 03/02/2015] [Indexed: 12/04/2022] Open
Abstract
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.
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Abstract
Choroidal osteomas are rare benign ossifying tumors that appear as irregular slightly elevated, yellow-white, juxtapapillary, choroidal mass with well-defined geographic borders, depigmentation of the overlying pigment epithelium; and with multiple small vascular networks on the tumor surface. Visual loss results from three mechanisms: Atrophy of the retinal pigment epithelium overlying a decalcified osteoma; serous retinal detachment over the osteoma from decompensated retinal pigment epithelium, and most commonly from choroidal neovascularization. Recent evidence points to the beneficial effects of intravitreal vascular endothelial growth factor antagonists in improving visual acuity in serous retinal detachment with or without choroidal neovascularization.
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Affiliation(s)
- Ramzi M Alameddine
- Department of Ophthalmology, American University of Beirut, Beirut, Lebanon
| | - Ahmad M Mansour
- Department of Ophthalmology, American University of Beirut, Beirut, Lebanon
| | - Eman Kahtani
- King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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Hayashi Y, Mitamura Y, Egawa M, Semba K, Nagasawa T. Swept-source optical coherence tomographic findings of choroidal osteoma. Case Rep Ophthalmol 2014; 5:195-202. [PMID: 25120475 PMCID: PMC4127548 DOI: 10.1159/000365184] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose To report the morphologic features of a choroidal osteoma using swept-source optical coherence tomography (SS-OCT) and fundus autofluorescence (FAF). Methods Two eyes of two cases with a choroidal osteoma were studied using SS-OCT and FAF. Results The location of the tumor was circumpapillary without macular involvement in case 1 and juxtapapillary with macular involvement in case 2. Both cases had a mixture of calcified and decalcified areas, and a concomitant choroidal neovascularization was found in case 2. The FAF images showed decreased autofluorescence in the central decalcified regions and relatively preserved fluorescence in marginal calcified regions in both cases. SS-OCT revealed a normal inner retina and an abnormal outer retina in both cases, and subretinal fluid in case 2. The calcified regions appeared sponge-like and were multilayered in case 2. A lamellar reflective pattern was observed in the decalcified regions in case 1, and hyperreflective mound-like areas were observed in both cases. SS-OCT demonstrated hyperreflective areas above Bruch's membrane accompanied by disruption of Bruch's membrane in case 1. The chorioscleral border was visible in both cases. Conclusions The FAF pattern in the calcified and decalcified areas of the choroidal osteoma may correspond to the different stage of tumor evolution. The SS-OCT findings indicate that choroidal osteomas can have characteristic reflective patterns and alterations of the overlying retina.
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Affiliation(s)
- Yuki Hayashi
- Department of Ophthalmology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Himeji, Japan
| | - Yoshinori Mitamura
- Department of Ophthalmology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Himeji, Japan
| | - Mariko Egawa
- Department of Ophthalmology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Himeji, Japan
| | - Kentaro Semba
- Department of Ophthalmology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Himeji, Japan
| | - Toshihiko Nagasawa
- Department of Ophthalmology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Himeji, Japan ; Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
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Dinah C, Sandinha T. Enhanced depth imaging as an adjunctive tool in the diagnosis of decalcified choroidal osteoma. Eye (Lond) 2014; 28:356-8. [PMID: 24406408 DOI: 10.1038/eye.2013.272] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- C Dinah
- Sunderland Eye Infirmary, Sunderland, UK
| | - T Sandinha
- Sunderland Eye Infirmary, Sunderland, UK
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Abstract
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.
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Affiliation(s)
- Tadanobu Yoshikawa
- Department of Ophthalmology, Kansai Medical University, Hirakata Hospital, Osaka, Japan
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