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G. William Aylward, FRCS, FRCOphth, MD; Tom S. Chang, FRCSC, MD; Scott E. Pautler, MD; J. Donald M. Gass, MD

Arch Ophthalmol. 1998;116:1337-1341.

Objective  To provide long-term follow-up information on a large series of patients with choroidal osteoma.

Methods  Review of patients with a diagnosis of choroidal osteoma who had been examined at the Bascom Palmer Eye Institute, Miami, Fla, or known to one of us (J.D.M.G.). Information was obtained from hospital medical records or by a questionnaire sent to referring ophthalmologists. Life-table analysis was used to study the loss of vision and development of choroidal neovascularization.

Results  We followed up 36 patients, 31 (89%) were female, mean age, 21 years (range, 5-54 years) for a mean of 10 years (range, 2-22 years). Growth was observed for 9 (41%) of 22 well-documented osteomas. The probability of loss of visual acuity to 20/200 or worse was 58% by 10 years and 62% by 20 years. The probability of developing choroidal neovascularization was 47% by 10 years and 56% by 20 years. Successful treatment of the choroidal neovascularization with laser photocoagulation was performed for 5 (25%) of 20 patients.

Conclusions  Most patients with choroidal osteomas maintain good vision in at least 1 eye, but they have a high risk of developing choroidal neovascularization. When this occurs, only a minority can be successfully treated with laser photocoagulation.

From the Bascom Palmer Eye Institute, Miami, Fla. Dr Aylward is now with Moorfields Eye Hospital, London, England; Dr Chang is now with the Department of Ophthalmology, University of British Columbia, Vancouver; Dr Pautler is now with the Department of Ophthalmology, University of South Florida, Tampa; and Dr Gass is now with the Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, Tenn.

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