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Photo Essay
August 1998

Rapid Enlargement of Choroidal Osteoma in a 3-Year-Old Girl

Author Affiliations


Arch Ophthalmol. 1998;116(8):1128-1129. doi:10.1001/archopht.116.8.1128

BILATERAL CHOROIDAL lesions were found in a 3-year-old Japanese girl during a follow-up examination for accommodative esotropia on December 18, 1994. Her medical history was unremarkable except for a high serum creatinine phosphokinase level.

A flat, yellow choroidal lesion was visible in each eye (Figure 1). Fluorescein angiography showed hypofluorescence at the early stage and hyperfluorescence at the late stage in both lesions (Figure 2). An early phase of indocyanine green angiography demonstrated hypofluorescence of the lesions due to blockage. In the late stage, staining of the lesion occurred (Figure 3). Ultrasonography (A- and B-scans) showed bilateral distinct choroidal lesions with high internal reflectivity consistent with calcification). Computed tomography revealed deposits of calcium in both eyes (Figure 4). The lesions were slightly enhanced by gadolinium in T1-weighted images of magnetic resonance imaging. The diagnosis of osteoma of the choroid was made from these findings. About 2 years later, the lesion had enlarged significantly in both eyes (Figure 5), as confirmed by fluorescein and indocyanine green angiography. At this time, her corrected visual acuity was still 20/30 OU without evidence of amblyopia. The patient has been followed up without medical treatment for the tumors.