Title

CASE REPORT: CHOROIDAL OSTEOMA WITH SUBRETINAL NEOVASCULAR MEMBRANE - MULTIMODAL ANALYSIS

Summary

Purpose: to describe findings of subretinal neovascular membrane in choroidal osteoma using multimodal analysis. Methods: Case report of a patient with choroidal osteoma treated at Sadalla Amin Ghanem Eye Hospital, in Joinville (SC), Brazil. The patient underwent complete ophthalmological examination, color fundus photography and autofluorescence (Canon CX-1– Tokyo, Japan), optical coherence tomography (OCT) (Cirrus HD-OCT model 5000 - Carl Zeiss Meditec, Dublin, CA), OCT angiography (OCT-A) ) (Angioplex – Cirrus HD-OCT model 5000 - Carl Zeiss Meditec, Dublin, CA) and ocular ultrasonography (Ultrascan, Alcon Labs, USA – Forthworth). Results: A 31-year-old healthy woman, complaining of central scotoma in her right eye (OD) two day before the first presentation. Best corrected visual acuity was 20/25 OD and 20/20 in her left eye. Fundoscopy revealed a subretinal whitish lesion in macular area, with subretinal hemorrhage in papilomacular bundle OD. Ultrasonography OD showed a lesion with increased reflectivity and echogenicity, suggesting calcium deposition. The OCT OD revealed choroid with sponge bone like appearance, choroidal excavation, outer retina tubulation and retinal pigment epithelium band thickening, suggesting choroidal neovascular membrane, confirmed by OCT angiography (OCT-A). The diagnosis of choroidal osteoma was made and the patient followed up. There were signs of subretinal fluid during the follow-up, with subsequent of intravitreal treatment with anti-VEGF (bevacizumab). After one injection, the patient remained stable during three months of follow-up. The last OCT did not show subretinal fluid. Conclusion: choroidal osteoma is a benign tumor, with typical findings on complementary exams. Choroidal neovascularization may ensue, causing reduced visual acuity. Physicians should be aware of this complication because anti-VEGF treatment can provide maintenance of visual acuity. Key words:choroidal osteoma, optical coherence tomography.

Area

CLINICAL CASE

Authors

Ana Paula da Silva Maganhoto, Lucas De Angelis Rubira, Victoria Souza Bogo, Fabio Bom Aggio