Purpose: A choroidal osteoma is a rare benign choroidal tumor involving the peripapillary and macular areas of young healthy
subjects with very slow growth and often with an acute decrease in vision. The main causes of this sudden decrease in vision
are a serous macular detachment or a subretinal hemorrhage, with or without choroidal neovascularization (CNV). A definitive
treatment for the CNV associated with a choroidal osteoma has not been established like photocoagulation, Intravitreal Anti
VEGF, surgical removal of the CNV, photodynamic therapy (PDT) and transpupillary thermotherapy.
Case Report:Thirty nine years old healthy man presented with the complaints of painless blurred vision in his both eyes
for 3 month . On examination,visual acuity was 3/60 in his right eye and 6/60 in his left eye. Fundus examination in both
eyes shows a flat, opaque, yellowish parapapillary choroidal lesion. In case of left eye there is grayish membrane associated
with minimal subretinal fluid suggestive of a CNVM, B-scan ultrasonography in both eyes revealed findings consistent with a
choroidal osteoma. Fundus fluorescein angiography 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 extrafoveal CNVM, Optical coherence tomography
confirmed the extrafoveal CNVM with subfoveal fluid, On the other hand in right eye there is no sign of CNVM other than
calcification. He was treated with laser photocoagulation in his left eye.
Results: On every 6 month follow up visit, vision in his right eye is sustained to 3/60 & in his left eye is 6/12 from 2011 to
till date. The FFA and OCT in left eye revealed a resolved CNVM. Treatment with laser photocoagulation may be an effective
alternative in the management of CNVM secondary to choroidal osteoma.
Conclusions: The long term visual prognosis without therapy is not good, our findings indicate that laser photocoagulation
prevents a decrease of vision in the short and long-term in a eye with a choroidal osteoma with CNV which is less invasive &
cost effective procedure in a developing country like Bangladesh.