Intravitreal ranibizumab for treatment of choroidal neovascularization secondary to a bilateral choroidal osteoma

Purpose Choroidal osteomas are benign intraocular tumors that classically present in females. Despite their benign nature, significant visual acuity loss can occur due to retinal pigment epithelium degeneration. We report an unusual case of bilateral choroidal osteoma in a young boy. Observation A 16 year old boy presented to the Aga Khan University Hospital with a history of painless, bilateral deteriorating vision over past few months. Examination showed best corrected visual acuity as 20/200 in the right eye and 20/400 in the left eye. Funduscopy revealed a well-defined lesion in the juxtafoveal region of both eyes. A diagnosis of (bilateral) choroidal osteoma was subsequently made on the basis of optical coherence tomography, fundus fluorescein angiography, Indocyanine green and B-scan ultrasonography. The presence of choroidal neovascularization with sub retinal fluid was also established on OCT. The patient was treated with three intravitreal Ranizumab injections. At the follow up visit, vision had improved to 20/50 in the right eye and 20/200 in the left. Sub retinal fluid had also resolved. Conclusions and importance: Intravitreal Ranizumab may be an effective alternative in the management of choroidal neovascularization secondary to choroidal osteoma.