Abstract
BackgroundChoroidal osteoma is rare clinical entity of unknown etiology, characterized by formation of mature cancellous bone within the choroid. It typically affects young females, with no racial predilection. Vision loss occurs mainly due to photoreceptor degeneration secondary to decalcification and/or development of choroidal neovascularization especially if located at the subfoveal area.Case presentationOur case is 9-year-old Indian (Indo-Aryan) boy identified incidentally with clinical features suggestive of choroidal osteoma with marked diminution of vision. Spectral domain optical coherence tomography demonstrated high reflectivity from the choroid and atrophy of the overlying retinal layers and B-scan ultrasound demonstrated multiple highly reflective calcified lesions within the choroid.ConclusionAlthough available literature shows that the occurrence of this rare clinical entity is more commonly seen in young females, our case report has shown that it may be seen at a very early age. The treatment options are still not available if significant atrophy of retinal pigment epithelium has already occurred; however, vision loss due to associated choroidal neovascularization may be treated with currently available treatment options. In our case, the vision loss was due to the significant atrophy of the retinal layers. Choroidal neovascularization was not seen and our patient was advised to attend follow-up regularly.
Highlights
Choroidal osteoma is rare clinical entity of unknown etiology, characterized by formation of mature cancellous bone within the choroid
Fundus fluorescein angiography (FFA) revealed areas of early granular hyperfluorescence corresponding to the areas of retinal pigment epithelium (RPE) depigmentation and late hyperfluorescence over the calcified lesion with some interspersed areas of hypofluorescence corresponding to the areas of pigment clumps in the left eye (Fig. 2)
In the largest case series on choroidal osteoma including 74 eyes of 61 patients followed up for a period of 26 years, Carol and colleagues demonstrated that choroidal osteoma is a disease of young females [2]
Summary
Choroidal osteoma is a rare benign disorder of unknown etiology; the literature showed a higher incidence in young females. It may occur at a very early age. The patient should be followed up regularly to detect the development of CNV or atrophy of retinal layers, so that loss of vision can be minimized. The strengths of this case report include its novelty; we describe a rare disease process involving the retina, with significant reduction in vision. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations
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