Intravitreal bevacizumab in the management of choroidal neovascular membrane secondary to choroidal osteoma.
OBJECTIVE
To describe a patient with choroidal neovascular membrane (CNVM) secondary to choroidal osteoma treated successfully with intravitreal bevacizumab.


METHODS
Case report. A 25-year-old healthy woman presented with complaints of sudden painless decrease in vision in the left eye (OS) of 1 month duration. On examination, visual acuity was 20/20 in the right eye (OD) and counting fingers at 1.5 meters OS. Slit lamp examination was unremarkable. Fundus examination OD was normal; OS demonstrated a flat, opaque, yellowish parapapillary choroidal lesion with adjacent subfoveal grayish membrane associated with minimal subretinal fluid suggestive of a CNVM. B-scan ultrasonography revealed findings consistent with a choroidal osteoma. Fundus fluorescein angiography (FFA) of the left eye revealed a relatively well-defined area of hyperfluorescence that increased in size and intensity in the later phases suggestive of active subfoveal CNVM. Optical coherence tomography (OCT) confirmed the subfoveal CNVM with altered foveal contour and distortion of foveal architecture. A diagnosis of subfoveal CNVM associated with choroidal osteoma was made. The patient was treated with intravitreal bevacizumab 1.25 mg in 0.05 mL OS and repeated 6 weeks later.


RESULTS
At the 4-month visit, vision OS improved to 20/125. The FFA and OCT revealed a resolved CNVM.


CONCLUSIONS
Intravitreal bevacizumab may be an effective alternative in the management of CNVM secondary to choroidal osteoma. Larger series of such cases need to be studied to further validate our findings.
Narayanan
R
R
LV Prasad Eye Institute, Hyderabad - India.
Shah
V A
VA
D000328:Adult; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D001859:Bone Neoplasms / Q000150:complications*; D002830:Choroid Neoplasms / Q000150:complications*; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007267:Injections; D010016:Osteoma / Q000150:complications*; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity; D014822:Vitreous Body
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab