A case of choroidal osteoma

Purpose Choroidal osteoma is a benign ossifying tumor of unknown etiology, is characterized by a slightly irregular elevated yellow–white lesion that typically occurs in healthy females in their early twenties or thirties. Associated complications include choroidal neovascularization (CNV) and subretinal hemorrhage. To date, no associations have been reported with ocular or systemic diseases; however, some reports suggest links with Stargard's and polypoidal maculopathies. Methods 17‐year‐old female was referred for complaints of blurring and decreased vision in the right eye who was diagnosed with choroidal neovascularization (CNV) associated with choroidal osteoma. Results We report the case of a 17‐year‐old female who presented to the hospital with complaints of blurring and decreased vision and loss of part of temporal visual field in the right eye. The patient had no systemic disease or family history of retinal lesions. Her visual acuity was 20/125 and 20/20 in the right and left eyes, respectively. Fundus examination of the right eye revealed a subretinal orange 4 × 3 disc diameter lesion with irregular distinct margins located in the superior retina with partial macular involvement. B‐scan indicated an echodense lesion sized 7.2 mm × 8.3 mm × 1.1 mm, with thick choroidal hemorrhage, strong shadowing, and subretinal calcification next to the optic disc. angiography showed dye leakage in the foveal region (CNV) and dye staining in an area of chronic retinal pigment epithelium (RPE) decompensation overlying the lesion. OCT indicated hyperreflectivity and subretinal fluid. Unilateral choroidal osteoma with secondary CNV was confirmed. The patient received intravitreal anti‐VEGF injection every 2 months. OCT was performed at each visit, indicating subretinal fluid. After 6 months, the clinical examination indicated a dry macular that was confirmed with OCT. There was functional improvement and anti‐VEGF injection continued for a total of seven injections over a period of almost 14 months. At the last visit, FFA indicated a stable dry macula, no CNV. The lesion size and vision were stable. The patient remains under observation. Conclusions Long‐term follow‐up is necessary to resolve the fluids, possible development of CNV, and possible of bilateral occurrence.