Sequential Anti-VEGF Therapy for Recurrent Choroidal Neovascularization Secondary to Choroidal Osteoma: A Case Report

Abstract

Choroidal osteoma is a rare benign ossifying choroidal tumor associated with vision-threatening complications, most commonly choroidal neovascularization (CNV). CNV secondary to choroidal osteoma can be difficult to manage due to high recurrence rates and variable response to treatment.A 35-year- old woman presented with curtain-like superotemporal visual field loss in her right eye without associated visual acuity loss. Upon examination, best-corrected visual acuity was 6/6 OU. Multimodal imaging confirmed the diagnosis of choroidal osteoma with secondary CNV. Patient initially responded well to sequential intravitreal anti- vascular endothelial growth factor (anti-VEGF) therapy; however, recurrence of CNV required switching treatment modalities to a newer- generation anti-VEGF agent. Five months after the treatment switch, the patient was asymptomatic with stable examination findings. Multimodal imaging allowed for confident diagnosis while newer-generation anti-VEGF agents appeared successful in managing recurrent CNV secondary to choroidal osteoma.