Optical coherence tomography angiography findings of choroidal neovascularization secondary to decalcified choroidal osteoma treated with intravitreal aflibercept A case report

Introduction: Choroidal osteoma (CO) is a rare benign ocular tumor characterized by ossifying choroid lesions. To the best of our knowledge, this is the first detailed report to describe the optical coherence tomography angiography (OCTA) findings of choroidal neovascularization (CNV) complicated by a rare decalcified CO following intravitreal aflibercept injection. Patient concerns: A 26-year-old woman presented with a spontaneous but painless reduction in visual acuity in her left eye that had commenced 5 days prior. Diagnosis: Clinical manifestations and multimodal imaging, including OCTA, spectral-domain optical coherence tomography, fundus fluorescein angiography and indocyanine green angiography, indicated decalcified CO with CNV. Interventions: After receiving an appropriately detailed explanation of the procedure, the patient was treated via intravitreal aflibercept(2.0 mg) injection once. Outcomes: One month after the therapy, OCTA revealed that the flow areas of CNV were narrowed, the best-corrected visual acuity was improved to 20/30, however, 2 months follow-up OCTA revealed that the CNV reoccurred, the best-corrected visual acuity was dropped to 20/50. Conclusion: Intravitreal aflibercept injection was an effective treatment for CO with CNV, but the effects may not last long. The OCTA findings provide a better appreciation of evaluating the effects of intravitreal aflibercept injection for CO complicating CNV.