Clinical case of bilateral rapidly progressive osteoma of the choroid

Choroidal osteoma is a benign neoplasm characterized by the appearance of mature bone tissues at the level of the choroid and unilateral development. This study highlights a clinical case of bilateral rapidly progressing osteoma of the choroid in a child, which was complicated by tumor decalcification and choroidal neovascularization. A 14-year-old male teen has been under observation in the S. Fyodorov Eye Microsurgery Federal State Institution, Saint-Petersburg branch since 2019, for bilateral choroidal osteoma. At the initial visit, a yellow-orange lesion with clear boundaries was noted in the left eye, localized at the level of the choroid and parapapillary, and had a trabecular bone structure. Based on the clinical picture and data from instrumental studies (ultrasound and optical coherence tomography), he was diagnosed with choroidal osteoma. During observation, a similar lesion appeared in the right eye, and its relatively rapid growth was observed in both eyes. Owing to the absence of zones of decalcification and neovascularization, further follow-up was initiated. However, in the presence of zones of decalcification of the bone tissue and newly formed vessels of the choroid, a threefold intravitreal injection of an angiogenesis inhibitor was performed. Consequently, regression of choroidal neovascularization was observed. Speculatively, the main reason for the atypical disease course in this teenager is the specificity of bone tissue development in childhood and adolescence.