Optical Coherence Tomography Angiography of Choroidal Osteoma and Intravitreal Aflibercept Management: Report of Two Cases


Optical Coherence Tomography Angiography of Choroidal Osteoma and Intravitreal Aflibercept Management Report of Two Cases by Ozgur Yucel, Muhammet Kazim Erol, Melih Akidan, Elcin Suren,Yusuf Akar, Turkey



To evaluate of optical coherence tomography angiography findings and the effect of intravitreal aflibercept management for subretinal fluid and choroidal neovascularization associated with choroidal osteoma.


Two eyes of two cases were studied using OCT-Angiography and including EDI-OCT, bulbar echography, fundus photography, fundus fluorescein angiography, computed tomography.


Case 1, a 19-year-old female presented with decreased visual acuity in the left eye for one week. EDI-OCT showed subretinal fluid, IS/OS layer distortion and horizontal lamellar lines under the focal choroidal excavation. OCT-Angiography showed decreased capillary dansity especially parafoveal area, subretinal fluid without CNV.Choroidal neovascularization associated with choroidal osteoma diagnosis was made. Intravitreal injection of aflibercept was performed. One month after single injection, vision of the left eye had improved. OCT and OCTA revealed complete resolution of subretinal fluid, increased capillary density and anatomical improvements. Case 2, a 62-year-old man was directed to suppose choroidal melanoma, metastases or age-related macular degeneration. EDI-OCT showed spongelike choroidal pattern, a part of sclerochoroidal junction. Subretinal fluid, CNV and fibrotic component was determined with OCTA. After complete ophthalmic examination and consultation to oncology clinic. Patient were diagnosed as choroidal osteoma-related CNV. It was not dramatic improvement in vision following 5 treatments of monthly injections with aflibercept. But OCT and OCTA showed complete resolution of subretinal fluid and stability for CNV.


Optical coherence tomography is non-invasive imaging system. It has ability to assess both structural and blood flow information. It helps to measure capilary density, foveal avascular zone and vascular flow. It provides information about microvascular abnormality especially CNV. Subretinal fluid with/without CNV-related choroidal osteoma can be treated with anti-VEGF theraphy. It helps to improve vision and anatomical structure. Larger studies are required to understand OCTA with choroidal osteoma and the long term effect of anti-VEGF management.


Muhammet Kazim Erol
Antalya, Turkey
Email : muhammetkazimerol@gmail.com
Cell Phone: +905055756182
Work Phone: +902422494400