MULTIPLE CHOROIDAL NEOVASCULARIZATIONS IN CHOROIDAL OSTEOMA TREATED WITH ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR INJECTIONS: A 6-YEAR FOLLOW-UP CASE REPORT.

Abstract

Purpose: The objective of this study was to report a case of multiple choroidal neovascularizations (CNVs) secondary to choroidal osteoma injected with a total of 13 anti-vascular endothelial growth factor drugs over a long-term follow-up of 6-year period.

Methods: This was a case report.

Results: A 29-year-old woman presented with a peripapillary choroidal osteoma in her left eye with the best-corrected visual acuity of 20/25. After 2 years of follow-up, two foci of CNV (one was at the infranasal of the optic disc and the other was near the subtemporal vascular arch) and massive subretinal hemorrhage developed overlying the osteoma, causing decreased best-corrected visual acuity of 20/33. The patient was treated with four consecutive intravitreal injections of conbercept, and the two CNVs regressed with the best-corrected visual acuity recovered to 20/25. While 17 months later, the third CNV lesion locating at the fovea appeared and nine more injections of aflibercept were given during which repeated recurrence of it occurred. At the last follow-up, 6 years from baseline, all the three CNV foci were controlled, with the final best-corrected visual acuity of 20/33.

Conclusion: Multiple CNVs may appear simultaneously at different locations in one osteoma, and prompt treatment with intravitreal anti-vascular endothelial growth factor may be a good option to control the progression and recurrence of these CNVs. Long-term follow-up and multimodal imaging are vital in the management of CO-associated CNV.