Electrophysiologic and echographic findings with choroidal osteoma

The explanation by differential diagnosis of pathological changes of the fundus may be particularly difficult in case of diseases of sporadic occurrence. The examination findings in a 19-year-old patient with a choroidal osteoma are presented. Large arciform, atrophic areas with distinct boundaries and star-shaped vascular structures were dominant in the fundus on both sides. With peripapillar manifestation, the optic nerve head was ophthalmoscopically noncontributory. A submacular bleeding had caused sudden reduction of visual acuity and caused the patient to visit the ophthalmologist. The most important diagnostic key was supplied by echography, which established peripapillar scleral calcification. The posterior eye segment was highly reflective in ultrasonic echography (B mode), showing concave deformation and causing the sound shadow. Visually evoked potentials indicated the onset of the compression of the optic nerve by the choroidal osteoma. Diagnostic and treatment possibilities are discussed.