Ocular imaging in the diagnosis of choroidal osteoma

Abstract

Objective: To describe the findings made by ocular ultrasonography (A- and B-scans) and spectral domain optical coherence tomography (SD-OCT) for diagnostic imaging in case patients with choroidal osteoma.
Clinical cases: Presentation of two cases (three eyes) of young women (22 and 26 years of age) with visual acuity loss and yellowish-white lesions in the eye fundus. B-scan ocular ultrasonography revealed calcified plaques with posterior echogenic shadows, while standardized A-scan ultrasonography showed a spike of very high reflectivity (100%). In one of the cases, SD-OCT was performed, and it evidenced subretinal hyper-reflective thickening with areas of retinoschisis of the external layers of the retina in one eye, and presence of intra- and subretinal fluid in the macular area associated with subretinal hyper-reflective material in the other eye. These findings confirmed the diagnosis of choroidal osteoma.
Conclusions: Echoes of high reflectivity were observed on standardized A-scan images as well as in B-scans; the osteoma had high reflectivity and it persisted even in lower gains. SD-OCT complemented the information with typical hyper-reflective images.