Bilateral Multifocal Choroidal Osteoma with Choroidal Neovascularization

Choroidal osteoma has been reported to be unilateral in approximately 80% of cases diagnosed with this condition. Herein we report the clinical characteristics and multimodal imaging findings in a rare case of bilateral multifocal choroidal osteoma. A 32-year-old female presented with decreased visual acuity (VA) in the right eye (20/100), though she had normal VA (20/20) in the left eye. Ophthalmoscopy and multimodal imaging investigation revealed bilateral multifocal choroidal osteoma complicated by choroidal neovascularization (CNV) in the right eye. Following three injections of intravitreal bevacizumab (IVB) for CNV in the right eye, VA improved to 20/40.

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Secondary choroidal neovascularization due to choroidal osteoma after 9 years follow-up

BMC Ophthalmology ◽

10.1186/s12886-021-02004-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yun Zhang ◽

Jia Fang ◽

Shixin Zhao ◽

Xiangjun She ◽

Jun Wang ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Choroidal Neovascularization ◽

Optical Coherence Tomography Angiography ◽

Fluorescence Angiography ◽

Optical Coherence ◽

Vascular Changes ◽

Choroidal Osteoma ◽

The Right

Abstract Background Choroidal osteoma is a benign intraocular tumor that can increase risk of developing choroidal neovascularization. The visual prognosis is influenced by the tumor location, decalcification status, overlying RPE atrophy, presence of choroidal neovascularization, persistence of subretinal fluid and occurrence of subretinal hemorrhages. Case presentation The authors present a 40-year-old woman diagnosed with choroidal osteoma of the right eye. Her best corrected visual acuity was 12/20 but decreased to 5/20 due to secondary choroidal neovascularization after 8 years follow up. Fundus examination revealed an enlarged choroidal osteoma in most margins at posterior pole with schistose hemorrhage beside macula. Optical coherence tomography angiography revealed unique features in the vascular changes of choroidal neovascularization in choroidal osteoma in the outer retinal layer and choroid capillary layers, and subretinal neovascularization. Indocyanine green fluorescence angiography showed there was hypo-fluorescence at the peripapillary with faint hyper-fluorescence at the macular, corresponding to the location on the fundus photograph. The patient received 3 injections of intravitreal ranibizumab. After 1 year follow up, her visual acuity of the right eye was 18/20 and the CNV had regressed. Conclusions We present the findings and treatment of a case of choroidal osteoma with secondary choroidal neovascularization. Optical coherence tomography angiography combined with FFA and ICGA is used to analysis the characteristics of secondary choroidal neovascularization. Optical coherence tomography angiography can reveal some unique characteristics in the vascular changes compared to fundus fluorescein angiography.

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Focal Choroidal Excavation in a Case of Choroidal Osteoma Associated with Choroidal Neovascularization

Journal of Ophthalmic and Vision Research ◽

10.18502/jovr.v15i3.7461 ◽

2020 ◽

Author(s):

Mahdieh Azimizadeh ◽

Seyedeh Maryam Hosseini ◽

Esmaeil Babaei

Keyword(s):

Choroidal Neovascularization ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Subretinal Fluid ◽

Retinal Hemorrhage ◽

Retinal Layers ◽

Choroidal Osteoma ◽

Focal Choroidal Excavation ◽

Neurosensory Retina ◽

The Right

Purpose: To report a case of choroidal osteoma associated with reactivation of choroidal neovascularization (CNV) and development of focal choroidal excavation (FCE). Case Report: A 34-year-old woman with choroidal osteoma complicated by CNV in the right eye for two years presented with deterioration of visual acuity in her right eye. A small retinal hemorrhage accompanied by subretinal fluid (SRF) was seen in the macular area of the right eye. Optical coherence tomography (OCT) showed that the inner retina was intact, and the outer retinal layers had outward displacement. SRF and a wedge-shaped choroidal depression were also seen. This choroidal excavation was not present on previous OCT images. The integrity of the inner retinal layers was maintained, and an optically clear space was present between the neurosensory retina and the retinal pigment epithelium. Conclusion: Choroidal osteoma can be complicated by CNV and FCE could occur as a consequence. Again, FCE can lead to CNV development. This cascade can deteriorate vision and sometime lead to permanent visual loss.

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Delayed-onset unilateral Vogt-Koyanagi-Harada syndrome: a multimodal imaging appraisal

BMJ Case Reports ◽

10.1136/bcr-2020-238623 ◽

2021 ◽

Vol 14 (2) ◽

pp. e238623

Author(s):

Saurabh Verma ◽

Himani Thakur ◽

Shorya Vardhan Azad ◽

Vinod Kumar

Keyword(s):

Multimodal Imaging ◽

Intravitreal Bevacizumab ◽

Choroidal Neovascularisation ◽

Enhanced Depth Imaging ◽

Depth Imaging ◽

Delayed Onset ◽

First Case ◽

Imaging Optical Coherence Tomography ◽

The Right ◽

Active Inflammation

A 38-year-old woman who had previously been diagnosed and treated for unilateral Vogt-Koyanagi-Harada syndrome (VKH) and had undergone multiple intravitreal bevacizumab injections to manage inflammatory choroidal neovascularisation in her right eye, presented 2 years later with visual complains in left eye. Clinical examination, fluorescein angiography, indocyanine green angiography (ICGA) and enhanced depth imaging optical coherence tomography (EDI-OCT) assisted evaluation confirmed active inflammation of left eye along with absence of any inflammation in the right eye. Unilateral active inflammation can be seen in the setting of VKH. To our best knowledge, ours is the first case of VKH in which unilateral active inflammation has been proven based on ICGA and EDI OCT analysis.

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

Case Reports in Ophthalmology ◽

10.1159/000508032 ◽

2020 ◽

Vol 11 (2) ◽

pp. 370-376

Author(s):

William J. Carroll ◽

Yi Stephanie Zhang ◽

Lee M. Jampol ◽

Manjot K. Gill

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Choroidal Neovascularization ◽

Optical Coherence Tomography Angiography ◽

Initial Evaluation ◽

Optical Coherence ◽

Choroidal Osteoma ◽

Anti Vegf ◽

Subsequent Response ◽

Intraretinal Fluid

In this study, we report the initial evaluation of choroidal neovascularization (CNV) secondary to choroidal osteoma and subsequent response to anti-vascular endothelial growth factor (anti-VEGF) treatment monitored with optical coherence tomography angiography (OCT-A). A 38-year-old female presented with an initial visual acuity of 20/150 in the left eye. Clinical examination revealed a choroidal osteoma. OCT demonstrated both subretinal and intraretinal fluid. OCT-A was performed and showed CNV. A course of ten treatments with ranibizumab showed an improvement of visual acuity to 20/30–3, improvement of subretinal and intraretinal fluid, as well as attenuation of CNV. Our report demonstrates OCT-A as a useful tool for both initial evaluation of CNV and following treatment response to anti-VEGF therapy.

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Large choroidal excavation in pachychoroid disease: A case report

European Journal of Ophthalmology ◽

10.1177/1120672119892428 ◽

2019 ◽

pp. 112067211989242 ◽

Cited By ~ 2

Author(s):

Pierluigi Iacono ◽

Maurizio Battaglia Parodi ◽

Sandro Saviano ◽

Mariacristina Parravano ◽

Monica Varano

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Indocyanine Green ◽

Choroidal Neovascularization ◽

Indocyanine Green Angiography ◽

Fundus Examination ◽

Corrected Visual Acuity ◽

Focal Choroidal Excavation ◽

The Right ◽

Best Corrected Visual Acuity

Purpose: To report the morphological and clinical features of a case of pachychoroid disease with focal choroidal excavation and large choroidal excavation complicated by choroidal neovascularization. Methods: The patient underwent a complete ophthalmologic examination including best-corrected visual acuity assessment, anterior segment and dilated fundus examination, fluorescein and indocyanine green angiography, and spectral-domain optical coherence tomography. Results: During the previous follow-up, the 57-year-old man received a diagnosis of central serous chorioretinopathy in the right eye with a late appearance of a choroidal neovascularization. The best-corrected visual acuity was 20/125 and 20/20 in the right and left eye, respectively. Dilated fundus examination, fluorescein angiography, and indocyanine green angiography confirmed a large subretinal fibrosis corresponding to the evolution of the choroidal neovascularization in the right eye. Spectral-domain optical coherence tomography clearly demonstrated in the right eye a large choroidal excavation below the fibrotic neovascular lesion with multiple hyperreflective foci inside the cavity, and in the left eye, a conforming focal choroidal excavation, bowl-shape type, associated with increased choroidal thickness with pachyvessels. Conclusion: Large choroidal excavation has been rarely reported. Although the pathogenetic mechanisms leading to the formation of large choroidal excavation are still only hypotheses, a combination of primary degenerative inflammatory factors sustaining the focal choroidal excavation formation and disruptive process of the choroidal neovascularization could be retained responsible for the large choroidal excavation.

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Extraskeletal Chondroma of the Preauricular Region: A Case Report and Literature Review

Case Reports in Medicine ◽

10.1155/2012/121743 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 10

Author(s):

Futoshi Watanabe ◽

Tadahiko Saiki ◽

Yoshihisa Ochochi

Keyword(s):

Magnetic Resonance Imaging ◽

Differential Diagnosis ◽

Rare Case ◽

Clinical Characteristics ◽

Hyaline Cartilage ◽

Surrounding Tissue ◽

Resonance Imaging ◽

En Bloc ◽

Cartilaginous Tumor ◽

The Right

An extraskeletal chondroma is a rare benign cartilaginous tumor that develops in soft tissue. Histologically, it is a lobulated nodule surrounded by a fibrous capsule; the inside consists of mature hyaline cartilage containing a few normal chondrocytes. We present a rare case of extraskeletal chondroma in the preauricular region. A 43-year-old man presented with a 2-cm-diameter right preauricular tumor that had been developing for 1 year. Magnetic resonance imaging showed a solid lobulated tumor in the right preauricular region, which was proximate to the capsule of the right temporomandibular joint (TMJ). This was subsequently resected under general anesthesia. The tumor was not in contact with the TMJ capsule and had not invaded the surrounding tissue, facilitatingen blocexcision. Histopathologically, the tumor comprised mainly of hyaline cartilage containing chondrocytes with chondrocytic lacunae and was diagnosed as a chondroma. The postoperative period was uneventful, and there was no evidence of recurrence at the 2-year followup. We describe the clinical characteristics of our case and review the literature, emphasizing the differential diagnosis.

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Macular Telangiectasia Type 2 With Spontaneous Resolution of Intraretinal/Sub-Internal Limiting Membrane Hemorrhage in the Absence of Neovascularization

Journal of VitreoRetinal Diseases ◽

10.1177/2474126417731478 ◽

2017 ◽

Vol 1 (6) ◽

pp. 415-419 ◽

Cited By ~ 1

Author(s):

Varun Chandra ◽

Rohan Merani ◽

Alex P. Hunyor ◽

I-Van Ho ◽

Mark Gillies

Keyword(s):

Visual Acuity ◽

Multimodal Imaging ◽

Internal Limiting Membrane ◽

Macular Telangiectasia ◽

Corrected Visual Acuity ◽

Visual Improvement ◽

Macular Telangiectasia Type 2 ◽

The Right

Purpose: To describe a case of macular telangiectasia type 2 (MacTel) presenting with decreased vision due to intraretinal/sub-internal limiting membrane (ILM) hemorrhage in the absence of neovascularization. Method: Clinical examination and multimodal imaging were performed. Results: A 65-year-old female presented with blurred left vision, recording 20/160 in that eye. There was intraretinal hemorrhage at the left macula centrally, with sub-ILM hemorrhage superiorly and inferiorly. Optical coherence tomography (OCT) showed no evidence of subretinal neovascularization. Imaging of the right macula was consistent with MacTel. The blood spontaneously cleared and the left visual acuity gradually improved to 20/25 by 4 months. Fluorescein angiography confirmed MacTel, and once the hemorrhage resolved, both inner and outer retinal cavitation was identified on OCT of the left macula. The left best-corrected visual acuity remained at 20/25 at 2-year follow-up. Conclusion: Spontaneous resorption of hemorrhage was accompanied by visual improvement.

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Two-Year Outcome of Aflibercept for the Treatment of Choroidal Neovascularization in Punctate Inner Choroidopathy

Case Reports in Ophthalmology ◽

10.1159/000496143 ◽

2019 ◽

Vol 10 (1) ◽

pp. 24-31 ◽

Cited By ~ 4

Author(s):

Luis Arrevola ◽

María Almudena Acero ◽

María Jesús Peral

Keyword(s):

Visual Acuity ◽

Case Report ◽

Choroidal Neovascularization ◽

Single Case ◽

Case Reports ◽

Oral Prednisone ◽

Case Series ◽

Punctate Inner Choroidopathy ◽

Single Case Report ◽

The Right

Punctate inner choroidopathy (PIC) is a rare inflammatory chorioretinopathy that predominantly affects young myopic women. Visual prognosis is generally good, but occurrence of choroidal neovascularization (CNV) is common and may be vision threatening. Case reports and short case series support the effectiveness of intravitreal anti-vascular endothelial growth factor (VEGF) agents (ranibizumab and bevacizumab) for CNV associated with PIC given their anti-angiogenic and anti-inflammatory effects. Evidence concerning aflibercept, a more recent intravitreal anti-VEGF, is limited to a single case report. In this case report, we illustrate the case of a 43-year-old myopic woman presenting with visual acuity loss and distortion in the right eye over the last 5 days in whom CNV associated with PIC was diagnosed. Treatment with 1 injection per month of intravitreal aflibercept for 2 months and full-dose oral prednisone for 1 week, being tapered afterwards, improved visual acuity and resolved CNV, with benefits lasting up to 24 months.

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Evaluation of Idiopathic Choroidal Neovascularization with Indocyanine Green Angiography in Patients Undergoing Bevacizumab Therapy

Journal of Ophthalmology ◽

10.1155/2015/642624 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Ryan B. Rush ◽

Sloan W. Rush

Keyword(s):

Visual Acuity ◽

Indocyanine Green ◽

Choroidal Neovascularization ◽

Indocyanine Green Angiography ◽

Clinical Course ◽

Intravitreal Bevacizumab ◽

Clinical Implications ◽

Snellen Visual Acuity ◽

Icg Angiography

Purpose. To examine the clinical implications of change in choroidal neovascularization (CNV) size on indocyanine green (ICG) angiography in subjects with idiopathic CNV undergoing bevacizumab therapy.Methods. The charts of subjects with an idiopathic CNV treated by a modified PRN regimen with intravitreal bevacizumab over a 12-month period were retrospectively reviewed.Results. There were 34 subjects included in the analysis. Baseline CNV sizes of less than 1.0 mm2on ICG angiography correlated with complete CNV resolution (P=0.0404), fewer injections delivered (P=0.0002), and better Snellen visual acuity (P=0.0098) at 12 months. Subjects that experienced a 33% or more reduction in CNV size on ICG angiography at 2 months had complete CNV resolution (P=0.0047) and fewer injections (P<0.0001) at 12 months compared to subjects that did not experience a 33% or more reduction in CNV size on ICG angiography at 2 months.Conclusions. Smaller baseline CNV size on ICG angiography resulted in better visual acuity and fewer injections at 12 months, and a reduction of 33% or more in CNV size after 2 months may predict a better clinical course in subjects with idiopathic CNV undergoing bevacizumab therapy.

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