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Ben Brahem M, El Matri K, Fafloul Y, Chebbi A, Fekih O, Nacef L, El Matri L. Atypical case of choroidal osteoma associated to polypoidal choroidal vasculopathy and preretinal neovascular membrane. Eur J Ophthalmol 2024:11206721241249218. [PMID: 38644785 DOI: 10.1177/11206721241249218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
PURPOSE To report a very rare and atypical case of an elderly Caucasian female patient who developed perilesional multiple polypoidal choroidal vasculopathy (PCV) as a probable complication of choroidal osteoma (CO), associated to preretinal neovascular membrane overlying the lesion. METHODS Observational case report. CASE OBSERVATION A 60-year-old Caucasian woman presented with blurred vision in her right eye (RE). Fundus examination revealed a round white-yellowish calcified deep lesion in the juxta-papillary superior area, measuring 4 disc-diameters, with well-defined scalloped margins and an irregular surface. B-scan ultrasonography and orbital tomography confirmed the diagnosis of choroidal osteoma (CO). Further investigation with multimodal imaging including infracyanine green angiography, fluorescein angiography, swept source optical coherence tomography and angiography highlighted the presence of multiple aneurysmal choroidal dilations around the CO, corresponding to PCV. We also noted the presence of a preretinal neovascular membrane overlying the CO. The patient was monitored with regular follow-up since no signs of activity were detected on multimodal imaging. CONCLUSION Our case report represents an exceptional and atypical association between pre-retinal neovascularization, PCV and choroidal osteoma. While the mechanisms underlying the development of PCV and pre-retinal neovascularization in the setting of CO are not well understood, it is imperative for ophthalmologists to recognize this association as a potential cause of sudden vision loss in patients with CO, and to consider appropriate diagnostic and management strategies.
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Affiliation(s)
- Mohamed Ben Brahem
- Department of ophthalmology A, Institut Hédi Raies d'ophtalmologie de Tunis, Tunis, Tunisia
- Faculté de médecine de Tunis, Université Tunis - El Manar, Tunis, Tunisia
| | - Khaled El Matri
- Faculté de médecine de Tunis, Université Tunis - El Manar, Tunis, Tunisia
- Department of ophthalmology B, Institut Hédi Raies d'ophtalmologie de Tunis, Tunis, Tunisia
- Oculogenetic laboratory LR14SP01, Tunis, Tunisia
| | - Yousra Fafloul
- Faculté de médecine de Tunis, Université Tunis - El Manar, Tunis, Tunisia
- Department of ophthalmology B, Institut Hédi Raies d'ophtalmologie de Tunis, Tunis, Tunisia
- Oculogenetic laboratory LR14SP01, Tunis, Tunisia
| | - Amel Chebbi
- Faculté de médecine de Tunis, Université Tunis - El Manar, Tunis, Tunisia
- Department of ophthalmology C, Institut Hédi Raies d'ophtalmologie de Tunis, Tunis, Tunisia
| | - Olfa Fekih
- Department of ophthalmology A, Institut Hédi Raies d'ophtalmologie de Tunis, Tunis, Tunisia
- Faculté de médecine de Tunis, Université Tunis - El Manar, Tunis, Tunisia
| | - Leila Nacef
- Department of ophthalmology A, Institut Hédi Raies d'ophtalmologie de Tunis, Tunis, Tunisia
- Faculté de médecine de Tunis, Université Tunis - El Manar, Tunis, Tunisia
| | - Leila El Matri
- Faculté de médecine de Tunis, Université Tunis - El Manar, Tunis, Tunisia
- Department of ophthalmology B, Institut Hédi Raies d'ophtalmologie de Tunis, Tunis, Tunisia
- Oculogenetic laboratory LR14SP01, Tunis, Tunisia
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