Abstract
PurposeTo describe characteristics of choroidal osteomas (CO), using ocular ultrasound, fluorescein angiography, ultra-widefield retinal imaging, ultra-widefield autofluorescence, optical coherence tomography, enhanced-depth-imaging OCT, and OCT angiography (OCT-A).MethodsRetrospective, observational case series study. Clinical records from patients with diagnosis of CO who underwent complete imaging evaluation were analyzed.ResultsSixteen eyes from 11 patients were included. Mean patient age was 33.4 years (range 20–61), 72.7% were female, 100% were Hispanic, and 54.5% had unilateral CO. Median visual acuity was 20/150 (range 20/20–2000). CO was completely calcified in 25%, partially decalcified in 50%, and decalcified in 25%. Other features included choroidal neovascularization (18.75%), focal choroidal excavation (12.5%), choroidal depression associated to decalcification (18.75%), thinning of outer retina and photoreceptor layers over decalcified tumor (75%). Decreased fluorescence on FAF was observed in decalcified regions while relatively preserved fluorescence was observed in calcified regions.ConclusionsNowadays, diagnostic tests provide important information about each stage of choroidal osteoma. Progressive decalcification of the tumor might have a common pathogenic role for development of FCE or choroidal depression. OCT-A/FA proved to be valuable tools for detection of CNV in patients with CO.
Highlights
Choroidal osteoma (CO) is a rare benign tumor of the choroid, which is composed of mature bone and vascular channels [1,2,3,4]
focal choroidal excavation (FCE) and choroidal depression may represent distinct stages of focal decalcification of the tumor, this hypothesis is supported by the fact that we were able to follow one patient that developed choroidal concavity, situation that allowed us to see that this depression can grow overtime (Fig. 3)
Choroidal osteoma is an ossifying tumor involving the choroid, its natural course may include tumor growth, calcification and decalcification; visual acuity depends on choroidal neovascularization and retinal changes associated to decalcification [12]
Summary
Choroidal osteoma (CO) is a rare benign tumor of the choroid, which is composed of mature bone (trabecular and/or compact) and vascular channels [1,2,3,4]. CO is typically unilateral (80% of cases) and it usually affects young healthy female patients [6]. It arises in late childhood or early adulthood and its most common symptoms are blurred vision, metamorphopsia and presence of a scotoma [7]. Enhanced depth imaging OCT (EDI-OCT) is a recent addition of OCT, that has been able to reveal the presence of bone lamella, tubular lamella with optically empty center, vascular channels and trabecular bone in patients with CO [8, 9]
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