First Author: B.Juarez-Dominguez MEXICO
Co Author(s): L. Cernichiaro-Espinosa J. Jimenez-Sierra
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To demostrate how continuous anti-VEGF therapy is needed to avoid recurrent episodes of choroidal neovascularization secondary to atypical choroidal osteoma
A retrospective study that reports tumour growth and response to anti-VEGF therapy in two brothers with bilateral atypical osteoma and glaucoma during a follow up of 15 years. Echography demonstrates calcification and clinical appearance shows hypopigmented lesions around the optic disc and 360 peripheral mottling observed in familial cases. Fluorescein angiography and OCT are shown since diagnosis (before and after intravitreal anti-VEGF)
Tumour growth in a centrifugal pattern is evidenced. Peripheral mottling fuses after time with peripapilar lesion. There is no typical appearance of the tumour, but a previous report of a familial case shows similar peripheral changes. When anti-VEGF is suspended, active intrarretinal and prerretinal (vitreous) haemorrhages from choroidal neovascularization appear so continous therapy is instituted and control is achieved. Different anti-VEGF drugs (bevacizumab, ranibizumab and aflibercept) have been employed with no differences between them (all showed response after treatment) and recurrence when suspended more tan 3 months.
Continuous intravitreal anti-VEGF therapy is recomended for bilateral choroidal osteoma to avoid recurrent haemorrhages from choroidal neovascularization. Strict follow up with fluorescein angiography and OCT images must be implemented.