Predicting Visual Outcomes in Choroidal Osteoma Treated with Anti-vascular Endothelial Growth Factor

center dot PURPOSE: To determine potential factors associated with the long-term visual prognoses in patients with choroidal osteoma undergoing anti-vascular endothelial growth factor (VEGF) treatment.center dot DESIGN: Retrospective case series.center dot METHODS: Patients diagnosed at tertiary high-volume hospitals between January 2000 and December 2020 were evaluated. The primary outcome measure was vi-sual acuity at 5-year follow-up. The secondary outcome measures included factors associated with favorable vi-sion, defined as loss of < 1 line and > 20/200 vision.center dot RESULTS: Of 38 eyes from 36 patients (22 female, 61%; mean age 38 years) with choroidal osteoma, 23 eyes (61%) received anti-VEGF treatment (bevacizumab 1.25mg/0.05 cc, monthly or treat-and-extend) and 65% completed the 5 years of follow-up. All treated eyes had associated chorioretinal comorbidities (subretinal fluid 91%; choroidal neovascularization 74%; subretinal hem-orrhage 30%). Although there was significant vision loss by 5 years ( P = .002), 12 eyes (44%) had favorable out-comes. Only tumor thickness was significantly associated with unfavorable visual outcomes (OR 917.1, 95% CI 1.0-5687.7; P = .049). The optimal cut-off point predic-tive of visual outcomes was 1.4 mm, and tumor thickness > 1.4 mm was associated with unfavorable vision (OR 27.0, 95% CI 2.0-368.4; P = .013).center dot CONCLUSIONS: Among patients with choroidal os-teoma undergoing anti-VEGF therapy, a particular pa-tient subset presented with divergent outcomes with very poor vision. Tumor thickness appeared to be the differ-entiating factor and is thus a potential prognostic indica-tor for long-term visual prognoses. (Am J Ophthalmol 2022;244: 143-151. (c) 2022 Elsevier Inc. All rights re-served.)

Automated summary

Among patients with choroidal osteoma undergoing anti-VEGF therapy, tumor thickness may be an important factor for predicting long-term visual prognoses.