[Long-term follow-up and management of choroidal osteoma].
OBJECTIVE
To report the clinical characteristics, long-term follow-up and management of choroidal osteoma.


METHODS
Eighteen eyes of 12 cases (5 male and 7 female) of choroidal osteoma were studied. Best corrected vision, intraocular pressure, perimetry, anterior segment and eye fundus were examined routinely. Special tests included phytochrome of eye fundus, fluorescein angiography and/or indocyanine green angiography; B-ultrasonogram, CT, perimetry and electrophysiology. (1) Eight eyes of 6 cases treated with vitamins and anti-inflammatory drug and followed-up periodically for 1-26 years (median 2.5 years). (2) Four eyes of 2 cases were treated with Krypton laser photocoagulation, 2 of them were superimposed with transpupillary thermotherapy (TTT). (3) TTT was given primarily for 6 eyes of 4 cases with infrared dione laser; the spot size was 3 mm, 1-5 spots were conducted conjunctly to cover the tumor surface. Power was 800-1200 mw at 60-90 seconds. The procedure was completed in 1-3 recessions with an interval of 4-6 weeks.


RESULTS
(1) In the medical treatment group, gradual growth of the tumor with pseudopodium along the margin was disclosed. One eye showed spontaneously regression during the long-term follow-up. (2) Laser photocoagulation was effective for 2 eyes, but residual flat serous detachment around the optic disc persisted in another 2 eyes and subsided with TTT. (3) Choroidal osteoma complicated with CNV treated primarily with TTT, prominent improvement was demonstrated.


CONCLUSIONS
Choroidal osteoma grows gradually in the natural course and shows pseudopodial margin. Laser photocoagulation was effective for certain cases. TTT is a method of choice either used primarily or supplementary after laser photocoagulation, it is recommended for cases complicated with CNV.
Zhang
Cheng-fen
CF
Department of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College, Eye Research Center of Chinese Academy of Medical Sciences, Beijing 100730, China. zhangchengfen@yahoo.com.cn
Dong
Fang-tian
FT
Chen
You-xin
YX
Li
Zhi-qing
ZQ
Du
Hong
H
Han
Bao-ling
BL
D000328:Adult; D002648:Child; D002830:Choroid Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced; D017075:Laser Coagulation; D008297:Male; D010016:Osteoma / Q000175:diagnosis* / Q000628:therapy*