Choroidal osteomas are rare benign ossifying tumours with predominantly a female preponderance. They present as elevated, irregular yellow-white, irregular and well-defined lesions most commonly in a juxtapapillary location. They can result in vision loss in a number of ways: 1) Choroidal neovascular membrane (CNVM), 2) Atrophy of the retinal pigment epithelium overlying the osteoma, 3) Serous retinal detachment.
Objective: To provide follow-up information on a series of patients with choroidal osteoma.
Methods: Review of patients with a diagnosis of choroidal osteoma at the Royal Victoria Eye and Ear Hospital (RVEEH), Dublin, Ireland. Information was obtained from hospital records. We examined visual outcomes, development of complications and treatment provided.
Results: We followed 11 patients, all female, mean age 28 (11-51) over a 12-year period. Growth was observed in 2 (18%). The probability of developing CNVM was 27% at 12 years and loss of visual acuity to 6/18 or worse was 36% by 12 years. Photodynamic therapy (PDT) was utilized in 1 patient while Anti-VEGF treatment was given to 2 patients.
Conclusions: The majority of patients with choroidal osteomas maintain good vision, but do have a significant risk of developing CNVM. When this occurs, the current first line treatment is Anti-VEGF or PDT laser.
Audience Take Away:
- Be able to diagnose and propose different treatment modalities for choroidal osteomas
- Know the natural history of the condition
- Know the risk of developing serious co-morbidities as a result of the condition
- Audits can be conducted in other ophthalmology units