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A case of choroidal osteoma treated by photodynamic therapy and intravitreal bevacizumab injection Yuzen Kashima 1 , Atsushi Ichio 1 , Hiroko Enomoto 1 , Hisashi Matsubara 1 , Mineo Kondo 1 1Department of Ophthalmology, Mie University Graduate School of Medicine pp.801-807
Published Date 2019/6/15
DOI https://doi.org/10.11477/mf.1410213179
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Abstract Purpose:Although choroidal osteoma(CO)is a benign tumor within the choroid, vision may be compromised by serous retinal detachment(SRD)and choroidal neovascularization(CNV). We report a case of CO accompanied by SRD that showed favorable visual and anatomical outcomes after combination of photodynamic therapy(PDT)and intravitreal bevacizumab injection(IVB).

Case:A 47-year-old man was referred to us with decreased visual acuity and anorthopia in his right eye.

Findings:Best-corrected visual acuity(BCVA)was 1.0 in the right eye at his first hospital visit. The right eye showed a whitish-yellow elevated subretinal lesion with overlying pigmentary changes in the juxtapapillary regions and without involving the macula. Fluorescein and indocyanine green angiographies revealed no CNV. B-scan ultrasonography indicated a choroidal mass of high reflectivity and acoustic shadowing. Computed tomography(CT)additionally showed dense choroidal plaque, thereby leading to the diagnosis of CO. As optical coherence tomography revealed SRD in the macula, the patient underwent four sessions of IVB. However, there was almost no improvement of the SRD. Due to extension of this mass, we then performed reduced-fluence PDT. As this also had little effect, we subsequently performed a standard PDT combined with IVB, which led to remarkable improvement of the BCVA and SRD. There has been no recurrence of SRF in the one year since treatment, with the BCVA remaining stable.

Conclusion:PDT combined with IVB might be an effective therapy for CO accompanied by SRD and without CNV, for which IVB alone does not have any effect.


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電子版ISSN 1882-1308 印刷版ISSN 0370-5579 医学書院

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