Use of Aflibercept to Treat Choroidal Neovascularization Secondary to Choroidal Osteoma in a 7-Year-Old Child: A Multimodal Imaging Case Report.

PURPOSE: This study is aimed at reporting a case of choroidal osteoma in a young boy complicated by choroidal neovascularization (CNV) and describing its clinical course over 9 months following intravitreal aflibercept injections.

OBSERVATION: A 7-year-old boy presented with a 2-month history of decreased vision in his left eye. Clinical examination and multimodal imaging revealed a central choroidal osteoma complicated by an active CNV with associated subretinal hemorrhage and fluid. The patient was treated with intravitreal aflibercept under general anesthesia. Follow-up visits demonstrated early anatomical improvement, with resolution of subretinal hemorrhage and fluid. However, recurrent CNV activity and fluctuating visual acuity were observed.

CONCLUSION

Although choroidal osteoma is more commonly reported in adult females, it should also be considered in young boys. Early treatment with aflibercept was associated with short-term anatomical and transient functional improvements in the management of CNV secondary to choroidal osteoma. However, visual acuity fluctuated during follow-up visits, necessitating recurrent CNV injections. Therefore, regular follow-up is essential due to the risk of recurrence and to preserve long-term visual acuity. Given the rarity of this condition, further studies with larger sample sizes and extended follow-up periods are required to evaluate the effectiveness of anti-vascular endothelial growth factor therapy and establish evidence-based management guidelines.