Assessment of choroidal osteoma complicating choroidal neovascularization by optical coherence tomography angiography

Abstract

PurposeChoroidal osteoma (CO) frequently leads to progressive visual loss due to complications of secondary choroidal neovascularization (CNV).We report herein the function of optical coherence tomography angiography (OCTA) in observation of CO complicating CNV.MethodsA 25-year-old female presented to our hospital with chief complaint of sudden unilateral visual acuity decrease for one week, with metamorphopsia in the left eye. Her best corrected visual acuity was 0.12 in the left eye. Then complete ophthalmological examinations including fundus photography, B-scan ultrasound, fundus fluorescent angiography, and spectral-domain optical coherence tomography (SD-OCT) were performed. She was diagnosed as CO on the basis of these results. But the diagnosis could not explain the sudden visual loss and submacular hyperreflective lesion by SD-OCT. Furthermore, she underwent OCTA and indocyanine green angiography.ResultsA diagnosis of classic juxtafoveal CNV secondary to CO was made eventually. Then she was treated with an intravitreous injection of ranibizumab twice. The visual acuity got better and better during the treatment, and the efficacy was stable, giving rise to both subjective and anatomic improvement.ConclusionsOptical coherence tomography angiography has the advantage of varying the segmentation and scrolling through the different retinal layers, and layer-specific observation of blood flow in each layer. In addition, OCTA can measure the vessel area change of CNV and provide a better appreciation of CNV, observing the efficacy more elaboratively and quantizedly. OCTA makes promising noninvasive identification of the CO-related CNV.

The Role of Optical Coherence Tomography Angiography in Ranibizumab-Treated Choroidal Neovascularization in Choroidal Osteoma

“…Therefore, within this population, CNV has a relatively high occurrence and is a significant cause for visual morbidity and may portend a poor long-term visual prognosis [ 2 ]. Many reported cases of CNV and associated subretinal fluid in CO have resolved with a series of up to four anti-VEGF injections [ 4 , 5 , 6 , 7 ]. Our case required ten monthly injections of ranibizumab suggesting a more aggressive or refractory secondary CNV than those previously reported.…”

“…CNV was seen most commonly in tumors with an irregular surface or overlying hemorrhage. Optical coherence tomography angiography (OCT-A) has been shown to be effective in evaluating CNV in patients with CO and those treated with anti-vascular endothelial growth factor (anti-VEGF) therapy [ 3 , 4 , 5 , 6 , 7 ].…”

“…OCT-A imaging of CNV secondary to CO has now been described in patients who have been responsive to bevacizumab or ranibizumab [ 4 , 5 , 6 , 7 ]. Our current case presents the longest follow-up in the literature of treatment with anti-VEGF and documentation with OCT-A.…”

Optical coherence tomography angiography findings of choroidal neovascularization secondary to decalcified choroidal osteoma treated with intravitreal aflibercept

“…Optical coherence tomography angiography (OCTA) is a noninvasive imaging modality for depth-resolved visualization of retinal vasculature, which provides a high-resolution image of the microvasculature of the different layers in the retina. [ 3 ] It can detect the CNV and observe the morphology and flow areas of CNV without obscured details due to dye leakage in CO. [ 4 ]…”

Optical Coherence Tomography Angiography Detects Choriocapillaris Loss in Decalcification of Choroidal Osteoma

“…5 Several case reports have shown that OCTA is useful in detecting CNV secondary to choroidal osteoma. [6][7][8][9][10] However, choriocapillaris characteristics in choroidal osteoma have not been a focus in OCTA imaging. This study aims to evaluate the morphological findings of the choriocapillaris via OCTA in choroidal osteoma.…”