Intravitreal bevacizumab in the management of choroidal neovascular membrane secondary to choroidal osteoma

Abstract

Purpose: 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.