Choroidal osteoma with choroidal neovascular membrane: Successful treatment with intravitreal bevacizumab

An otherwise healthy 27-year-old woman presented with complaints of sudden painless blurred vision in the right eye for one week. On examination, visual acuity was 20/30 in the right eye and 20/20 in left eye. Fundus examination OS was normal, but OD demonstrated an elevated, opaque, yellowish parapapillary choroidal lesion with grayish membrane associated with minimal subretinal fluid, suggestive of a choroidal neovascular membrane in the center. B-scan ultrasonography revealed findings consistent with a choroidal osteoma. Fundus fluorescein angiography of the right eye revealed a relatively well defined area of hyperfluorescence that increased in size and intensity in the later phases, suggestive of active extrafoveal choroidal neovascular membrane. Optical coherence tomography confirmed the extrafoveal choroidal neovascular membrane with subfoveal fluid. She was treated with intravitreal bevacizumab OD. At the two-week visit, vision OD improved to 20/20. Fluorescein angiography and optical coherence tomography revealed a resolved choroidal neovascular membrane. Intravitreal bevacizumab may be an effective alternative in the management of choroidal neovascular membrane secondary to choroidal osteoma

Choroidal osteoma with CNVM – Successful treatment with intravitreal Bevacizumab

AbstractTwenty-seven years old healthy woman presented with complaints of sudden painless blurred vision in right eye for 1week. On examination, visual acuity was 20/30 in the right eye and 20/20 in left eye. Fundus examination OS was normal; OD demonstrated a flat, opaque, yellowish parapapillary choroidal lesion with grayish membrane associated with minimal subretinal fluid suggestive of a CNVM in the center. B-scan ultrasonography revealed findings consistent with a choroidal osteoma. Fundus fluorescein angiography of the right eye revealed a relatively well-defined area of hyperfluorescence that increased in size and intensity in the later phases suggestive of active extrafoveal CNVM. Optical coherence tomography confirmed the extrafoveal CNVM with subfoveal fluid. She was treated with intravitreal Bevacizumab OD. At the 2weeks visit, vision OD improved to 20/20. The FFA and OCT revealed a resolved CNVM. Intravitreal Bevacizumab may be an effective alternative in the management of CNVM secondary to choroidal osteoma

Validating the pachychoroid disease spectrum using multimodal imaging

Pachychoroid disease spectrum has garnered considerable interest and has been discussed in detail in recent literature. It refers to a group of retinal and choroidal disorders, namely pigment epitheliopathy, central serous chorioretinopathy, neovasculopathy, and polypoid choroidal vasculopathy, all arising from a thickened choroid and hyperpermeable large choroidal vessels. We describe a case which had simultaneous presentation of multiple disorders on the pachychoroid spectrum. Multimodal findings in this patient have been described in this report. The presence of pachychoroid should prompt thorough imaging since coexistence of multiple disorders can potentially change the management and follow-up schedule of these patients

Dowsing in a case of recurrent central serous Chorioretinopathy

We present a case of a 34-year-old male with diminution of vision in his left eye. He was diagnosed as a case of central serous chorioretinopathy (CSCR) on clinical examination and optical coherence tomography (OCT). The episode resolved in 1 month. Nine months later, the patient had a recurrence. This time, the CSCR was imaged using spectral domain-OCT, enhanced depth imaging-OCT, fundus autofluorescence, and fundus fluorescein angiography. The patient was noted to have an associated extrafoveal subretinal fluid pocket with a focal choroidal excavation