Choroidal Osteoma Complicated by Choroidal Neovascularization: A Case Report

A 13-year-old girl with no prior systemic or ocular comorbidities presented to the eye clinic at Shifa International Hospital, Islamabad, Pakistan, with complaints of blurred vision in her left eye. Fundus examination revealed a well-defined, yellow-orange lesion at the posterior pole. B-scan ultrasonography demonstrated an echo-dense lesion, most prominent at low gain, while swept source optical coherence tomography (SS-OCT) showed a hyperreflective choroidal mass with associated subretinal fluid (SRF). Based on these findings, a diagnosis of choroidal osteoma complicated by choroidal neovascularization (CNV) was established. This case report describes the management of a pediatric case of CNV related to choroidal osteoma with a series of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections over nine months, resulting in significant regression of CNV and a reduction in SRF. She continues to be monitored with multimodal imaging and intermittent therapy, demonstrating favorable anatomical and functional outcomes.