Predictive Factors and Tumor Dynamics in Choroidal Osteoma: A Multimodal Imaging-Based Longitudinal Analysis

Area of Science:

• Ophthalmology
• Medical Imaging
• Pathology

Background:

• Choroidal osteoma (CO) is a rare benign ossification of the choroid.
• Longitudinal changes and prognostic factors in CO are not fully understood.
• Multimodal imaging is crucial for evaluating intraocular tumors.

Purpose of the Study:

• To assess longitudinal changes in choroidal osteoma (CO) using multimodal imaging.
• To identify factors that predispose to CO-related complications and sequelae.
• To analyze the natural history and clinical significance of CO lesions.

Main Methods:

• Retrospective observational study of patients diagnosed with choroidal osteoma.
• Analysis of multimodal imaging parameters including osteoma area, RPE atrophy, and de-calcified choroidal atrophy (d-CA).
• Longitudinal follow-up data analyzed for changes in lesion characteristics and associated factors.

Main Results:

• 92 eyes from 73 patients were analyzed; 47.8% had choroidal neovascularization (CNVM).
• Baseline factors associated with CNVM included d-CA, RPE atrophy, and macular involvement.
• Increased d-CA correlated with larger baseline osteoma area and CNVM; RPE atrophy correlated with reduced osteoma thickness.

Conclusions:

• Retinal pigment epithelium (RPE) atrophy and de-calcified choroidal atrophy (d-CA) are significant prognostic factors in choroidal osteoma.
• Three distinct clinical zones within d-CA areas (calcified, transition, d-CA) have unique clinical significance.
• Multimodal imaging provides valuable insights into the progression and outcomes of choroidal osteoma.