Choroidal Osteoma Complicated by Choroidal Neovascularization: A Case Report

TL;DR

A 13-year-old girl with a rare eye condition called choroidal osteoma developed vision issues due to abnormal blood vessel growth, which was successfully treated with injections over nine months.

Contribution

This case report presents a rare pediatric case of choroidal osteoma complicated by choroidal neovascularization and its successful management with anti-VEGF therapy.

Findings

Intravitreal anti-VEGF injections led to significant regression of choroidal neovascularization.

Subretinal fluid decreased following treatment, resulting in improved anatomical and functional outcomes.

Multimodal imaging confirmed the effectiveness of the treatment approach over nine months.

Abstract

A 13-year-old girl with no prior systemic or ocular comorbidities presented to the eye clinic at Shifa International Hospital, Islamabad, Pakistan, with complaints of blurred vision in her left eye. Fundus examination revealed a well-defined, yellow-orange lesion at the posterior pole. B-scan ultrasonography demonstrated an echo-dense lesion, most prominent at low gain, while swept source optical coherence tomography (SS-OCT) showed a hyperreflective choroidal mass with associated subretinal fluid (SRF). Based on these findings, a diagnosis of choroidal osteoma complicated by choroidal neovascularization (CNV) was established. This case report describes the management of a pediatric case of CNV related to choroidal osteoma with a series of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections over nine months, resulting in significant regression of CNV and a reduction in SRF. She continues to be monitored with multimodal imaging and intermittent therapy, demonstrating favorable anatomical and functional outcomes.

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