A case of choroidal osteoma in a 5‐year‐old child

Abstract

AbstractPurposeTo report a case of choroidal osteoma (CO) in a 5‐year‐old boy.MethodsCase reportResultsA 5‐year‐old child presented with decreased vision in both eyes. His best‐corrected visual acuity (BCVA) was 20/50 in the right eye (OD) and 20/100 in the left eye (OS). The anterior segment was normal in both eyes. Cycloplegic refraction was +2.50 ‐2.25 x 10 in the OD and +3.25 ‐2.50 x 180 in the OS. Funduscopy of the OS revealed a large subretinal, yellowish lesion in the juxta‐papillary area. B‐scan ultrasonography of the OS revealed a dense echogenic plaque with acoustic shadowing. The axial CT scan also showed a calcified lesion in the posterior pole. Optical coherence tomography (OCT) was normal at the fovea but revealed subretinal fluid (SRF) at the superior temporal vascular arcade. Spectacle correction was prescribed and alternating part‐time occlusion was performed. The patient was asked to come for regular follow‐up. Six months later his BCVA was 20/25 in both eyes, no variations of the mass were noted and the SRF disappeared.ConclusionsOC is a rare, benign ossifying tumor. It is typically found in healthy young women, mostly unilateral, in the posterior pole of the eye, near the optic disc. It is relatively rare in children. OC must be differentiated mainly from amelanotic choroidal melanoma, choroidal nevus, choroidal hemangioma, choroidal metastasis, sclerochoroidal calcification and posterior scleritis. In children it can pose a serious diagnostic challenge as it can mimic other lesions at posterior pole, such us retinoblastoma, retinochoroidal coloboma, and toxoplasmic retinochoroiditis. Asymptomatic or stable CO can be observed. For choroidal neovascular membranes photodynamic therapy and laser treatment have been used in the past. More recently, anti‐VEGF treatments have been employed with success.