Choroidal osteoma: observations from a community setting.
OBJECTIVE
To determine the characteristics of choroidal osteoma arising from a previously unreported patient population and to document new observations in this condition.


METHODS
Retrospective, observational case series.


METHODS
Eleven consecutive patients seen from 1986 through 2002 with choroidal osteoma from one community-based retina practice.


METHODS
Laser ablation of subretinal neovascularization in two cases and focal laser treatment of retinal pigment epithelial leaks in one case.


METHODS
Photographs, fluorescein and indocyanine green angiograms, and clinical records were analyzed.


METHODS
Demographic variables, visual acuity, complications of laser treatment, growth of lesions, and associated funduscopic changes.


RESULTS
Choroidal osteoma from a community setting is more frequently asymptomatic (5/11 cases; 45%) than in previously reported university series, is usually initially misdiagnosed, and is not rare. Light-intensity focal laser photocoagulation for serous retinal detachment unaccompanied by subretinal neovascularization can resolve fluid (1/11 cases; 9%). Laser ablation of secondary subretinal neovascularization stimulates rapid choroidal osteoma vascular remodeling (2/11 cases; 18%) and can cause retina-osteoma venous and arterial anastomoses (1/11 cases; 9%). Spontaneous choroidal hemorrhage unaccompanied by subretinal neovascularization can occur with confinement to the osteoma borders (1/11 cases; 9%). Association of choroidal osteoma with retinitis pigmentosa is reported.


CONCLUSIONS
These data on choroidal osteoma natural history and treatment help clinicians managing these lesions. In the community, a higher index of suspicion for choroidal osteoma is warranted.
Browning
David J
DJ
Charlotte Eye, Ear, Nose, and Throat Associates, 6035 Fairview Road, Charlotte, NC 28210, USA. djbrowning@carolina.rr.com
D000293:Adolescent; D000328:Adult; D002648:Child; D002832:Choroid Hemorrhage; D002830:Choroid Neoplasms / Q000150:complications / Q000473:pathology*; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D010016:Osteoma / Q000150:complications / Q000473:pathology*; D012163:Retinal Detachment / Q000209:etiology / Q000601:surgery; D015861:Retinal Neovascularization / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D014792:Visual Acuity
D004396:Coloring Agents; D007208:Indocyanine Green