[Intravitreal injection of bevacizumab for CNV secondary to choroidal osteoma and follow-up by Spectral-Domain OCT].

BACKGROUND

Choroidal osteoma is a rare, ossifying tumor, which, while benign, may be complicated by choroidal neovascularization.

METHODS

An 11-year-old boy presented with blurred vision in the right eye for few days. Fundus examination showed bulky lesion in the posterior pole containing a sub-retinal hemorrhage. The geographic borders and color of the mass were typical of choroidal osteoma despite the unusual macular location. The diagnosis was confirmed by ultrasonography. The patient was treated with three successive intravitreal injections of 1.25 mg/0.05 mL bevacizumab (IVB) under general anesthesia, due to recurrences of neovascular activity. SD-OCT in EDI mode was carried out prior to each injection.

RESULTS

SD-OCT before and after each bevacizumab injection confirmed regression of serous retinal detachment (SRD) at various locations throughout the lesion, especially in the hemorrhagic zone. It also allowed us to differentiate the active decalcified zones from the inactive calcified zones and to follow treatment response.

DISCUSSION: The treatment of choroidal neovascularization (CNV) secondary to choroidal osteoma is not well defined. As for other etiologies of CNV, anti-VEGF agents (such as bevacizumab) appear to be effective in regressing CNV and improving visual function. In our young patient, general anesthesia was necessary to administer each injection. SD-OCT allows diagnostic confirmation and follow-up of treatment. EDI mode is helpful in studying the choroid and the osteoma.

CONCLUSION

We report a rare case of macular choroidal osteoma, examined by SD-OCT. CNV required several anti-VEGF injections, with good anatomical and functional results.