Swept-source optical coherence tomography analysis of choroidal osteoma_Chinese Journal of Ocular Fundus Diseases

Authors：

Xuan Yi ,  Wang Min , Chang Qing , Zhang Yongjin

Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai 200031, China;

Corresponding author：

Wang Min, Email: wangmin83@yahoo.com

Keywords：

Choroidal neoplasms/diagnosis; Tomography, optical coherence

DOI：

10.3760/cma.j.cn511434-20200323-00126

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To observe and analyze the image characteristics of eyes with choroidal osteoma using swept-source OCT (SS-OCT).Methods Seventy-three eyes of 61 patients with choroidal osteoma were enrolled in the study, including 17 males (20 eyes) and 44 females (53 eyes) with an average age of 33.5±12.7 years. Single tumor was found in 71 eyes and multiple tumors were found in 2 eyes. All patients received examinations of slit lamp ophthalmoscope, color fundus photography, fundus autofluorescence, fluorescein angiography and/or indocyanine green angiography, B-scan ultrasonography and/or computerized tomography. Tumor features were characterized using SS-OCT.Results Among 75 tumors of 73 eyes, the osteoma was completely calcified in 7 tumors, completely decalcified in 5 tumors and all the other tumors were composed of calcified and decalcified portions. SS-OCT revealed normal inner retina in all the calcified areas of tumors and abnormal outer retina including external limiting membrane, ellipsoid zone, interdigitation zone and RPE in some cases. Whereas the outer retina and RPE showed abnormality in the decalcified areas of all cases. The choriocapillaris was invisible in all cases and most of the medium and large caliber vessels showed thinning or nonvisibility. Choroidal osteoma revealed a sponge-like appearance (n=39), loofah sponge appearance (n=11), lamellar pattern (n=10), mixed (n=12) and irregular patterns (n=5). Other unique features included horizontal lamellar lines (n=71), hyperreflective horizontal lines (n=47) and hyporeflective tubules (horizontal:n=39, vertical:n=42, circular:n=41) within choroidal osteoma. Hyperreflective tumor-like tissues were also detected above the disrupted Bruch’s membrane. The sclero-choroidal junction was detectable in all tumors and a posterior ciliary vessel penetrating the sclera was also seen.Conclusions SS-OCT clearly reveals characteristic appearances of choroidal osteoma as sponge-like, loofah sponge, lamellar pattern, mixed and irregular patterns, with unique features of horizontal lamellar lines, hyperreflective horizontal lines and hyporeflective tubules within osteoma. Hyperreflective tumor-like tissues were detected to grow above the disrupted Bruch’s membrane.

Citation： Xuan Yi, Wang Min, Chang Qing, Zhang Yongjin. Swept-source optical coherence tomography analysis of choroidal osteoma. Chinese Journal of Ocular Fundus Diseases, 2020, 36(6): 435-441. doi: 10.3760/cma.j.cn511434-20200323-00126 Copy

1.	Gass JD, Guerry RK, Jack RL, et al. Choroidal osteoma[J]. Arch Ophthalmol, 1978, 96(3): 428-435. DOI: 10.1001/archopht.1978.03910050204002.
2.	Shields CL, Shields JA, Augsburger JJ. Choroidal osteoma[J]. Surv Ophthalmol, 1988, 33(1): 17-27. DOI: 10.1016/0039-6257(88)90069-0.
3.	Shields CL, Sun H, Demirci H, et al. Factors predictive of tumor growth, tumor decalcification, choroidal neovascularization, and visual outcome in 74 eyes with choroidal osteoma[J]. Arch Ophthalmol, 2005, 123(12): 1658-1666. DOI: 10.1001/archopht.123.12.1658.
4.	Bessho H, Imai H, Azumi A. The histopathological finding of the surgically extracted atypical dome-shaped choroidal osteoma[J/OL]. Case Rep Ophthalmol Med, 2017, 2017: 2874823[2017-03-15]. http://europepmc.org/article/MED/28396814. DOI: 10.1155/2017/2874823.
5.	Fukasawa A, Iijima H. Optical coherence tomography of choroidal osteoma[J]. Am J Ophthalmol, 2002, 133(3): 419-421. DOI: 10.1016/s0002-9394(00)00503-1.
6.	Shields CL, Perez B, Materin MA, et al. Optical coherence tomography of choroidal osteoma in 22 cases: evidence for photoreceptor atrophy over the decalcified portion of the tumor[J]. Ophthalmology, 2007, 114(12): 53-58. DOI: 10.1016/j.ophtha.2007.07.037.
7.	薛康, 钱江, 张勇进, 等. 脉络膜骨瘤的频域光相干断层扫描观察[J]. 中华眼底病杂志, 2013, 29(5): 479-482. DOI: 10.3760/cma.j.issn.1005-1015.2013.05.008.Xue K, Qian J, Zhang YJ, et al. Spectral domain-optical coherence tomography analysis of choroid osteoma[J]. Chin J Ocul Fundus Dis, 2013, 29(5): 479-482. DOI: 10.3760/cma.j.issn.1005-1015.2013.05.008.
8.	李娟娟, 黎铧, 王萍. 脉络膜骨瘤多种眼底影像特征对比观察[J]. 中华眼底病杂志, 2016, 32(3): 283-286. DOI: 10.3760/cma.j.issn.1005-1015.2016.03.013.Li JJ, Li H, Wang P. Comparative observation of choroidal osteoma by multimodal fundus imaging methods[J]. Chin J Ocul Fundus Dis, 2016, 32(3): 283-286. DOI: 10.3760/cma.j.issn.1005-1015.2016.03.013.
9.	Hayashi Y, Mitamura Y, Egawa M, et al. Swept-source optical coherence tomographic findings of choroidal osteoma[J]. Case Rep Ophthalmol, 2014, 5(2): 195-202. DOI: 10.1159/000365184.
10.	Yang J, Wang E, Yuan M, et al. Three-dimensional choroidal vascularity index in acute central serous chorioretinopathy using swept-source optical coherence tomography[J]. Graefe's Arch Clin Exp Ophthalmol, 2020, 258(2): 241-247. DOI: 10.1007/s00417-019-04524-7.
11.	Trimble SN, Schatz H, Schneider GB. Spontaneous decalcification of a choroidal osteoma[J]. Ophthalmology, 1988, 95(5): 631-634. DOI: 10.1016/s0161-6420(88)33144-1.
12.	Sisk RA, Riemann CD, Petersen MR, et al. Fundus autofluorescence findings of choroidal osteoma[J]. Retina, 2013, 3(1): 97-104. DOI: 10.1097/IAE.0b013e31825c1cde.
13.	Navajas EV, Costa RA, Calucci D, et al. Multimodal fundus imaging in choroidal osteoma[J]. Am J Ophthalmol, 2012, 153(5): 890-895. DOI: 10.1016/j.ajo.2011.10.025.
14.	Ide T, Ohguro N, Hayashi A, et al. Optical coherence tomography patterns of choroidal osteoma[J]. Am J Ophthalmol, 2000, 130(1): 131-134. DOI: 10.1016/s0002-9394(00)00503-1.
15.	Freton A, Finger PT. Spectral domain-optical coherence tomography analysis of choroidal osteoma[J]. Br J Ophthalmol, 2012, 96(2): 224-228. DOI: 10.1136/bjo.2011.202408.
16.	Pellegrini M, Invernizzi A, Giani A, et al. Enhanced depth imaging optical coherence tomography features of choroidal osteoma[J]. Retina, 2014, 34(5): 958-963. DOI: 10.1097/iae.0000000000000017.
17.	Williams AT, Font RL, Van Dyk HJ, et al. Osseous choristoma of the choroid simulating a choroidal melanoma: association with a positive 32P test[J]. Arch Ophthalmol, 1978, 96(10): 1874-1877. DOI: 10.1001/archopht.1978.03910060378017.
18.	Haruta M, Hangai M, Taguchi C, et al. Spectral-domain optical coherence tomography of the choroid in choroidal osteoma[J]. Ophthalmic Surg Lasers Imaging, 2011, 42: 118-121. DOI: 10.3928/15428877-20111201-04.
19.	Shields CL, Arepalli S, Atalay HT, et al. Choroidal osteoma shows bone lamella and vascular channels on enhanced depth imaging optical coherence tomography in 15 eyes[J]. Retina, 2015, 35(4): 750-757. DOI: 10.1097/iae.0000000000000376.
20.	Zweifel SA, Engelbert M, Laud K, et al. Outer retinal tubulation: a novel optical coherence tomography finding[J]. Arch Ophthalmol, 2009, 127(12): 1596-1602. DOI: 10.1001/archophthalmol.2009.326.
21.	Xuan Y, Zhang Y, Wang M, et al. Multimodal fundus imaging of outer retinal tubulations in choriodal osteoma patients[J]. Retina, 2018, 38(1): 49-59. DOI: 10.1097/iae.0000000000001498.
22.	Hariri A, Nittala MG, Sadda SR. Outer retinal tubulation as a predictor of the enlargement amount of geographic atrophy in age-related macular degeneration[J]. Ophthalmology, 2015, 122(2): 407-413. DOI: 10.1016/j.ophtha.2014.08.035.

1. Gass JD, Guerry RK, Jack RL, et al. Choroidal osteoma[J]. Arch Ophthalmol, 1978, 96(3): 428-435. DOI: 10.1001/archopht.1978.03910050204002.
2. Shields CL, Shields JA, Augsburger JJ. Choroidal osteoma[J]. Surv Ophthalmol, 1988, 33(1): 17-27. DOI: 10.1016/0039-6257(88)90069-0.
3. Shields CL, Sun H, Demirci H, et al. Factors predictive of tumor growth, tumor decalcification, choroidal neovascularization, and visual outcome in 74 eyes with choroidal osteoma[J]. Arch Ophthalmol, 2005, 123(12): 1658-1666. DOI: 10.1001/archopht.123.12.1658.
4. Bessho H, Imai H, Azumi A. The histopathological finding of the surgically extracted atypical dome-shaped choroidal osteoma[J/OL]. Case Rep Ophthalmol Med, 2017, 2017: 2874823[2017-03-15]. http://europepmc.org/article/MED/28396814. DOI: 10.1155/2017/2874823.
5. Fukasawa A, Iijima H. Optical coherence tomography of choroidal osteoma[J]. Am J Ophthalmol, 2002, 133(3): 419-421. DOI: 10.1016/s0002-9394(00)00503-1.
6. Shields CL, Perez B, Materin MA, et al. Optical coherence tomography of choroidal osteoma in 22 cases: evidence for photoreceptor atrophy over the decalcified portion of the tumor[J]. Ophthalmology, 2007, 114(12): 53-58. DOI: 10.1016/j.ophtha.2007.07.037.
7. 薛康, 钱江, 张勇进, 等. 脉络膜骨瘤的频域光相干断层扫描观察[J]. 中华眼底病杂志, 2013, 29(5): 479-482. DOI: 10.3760/cma.j.issn.1005-1015.2013.05.008.Xue K, Qian J, Zhang YJ, et al. Spectral domain-optical coherence tomography analysis of choroid osteoma[J]. Chin J Ocul Fundus Dis, 2013, 29(5): 479-482. DOI: 10.3760/cma.j.issn.1005-1015.2013.05.008.
8. 李娟娟, 黎铧, 王萍. 脉络膜骨瘤多种眼底影像特征对比观察[J]. 中华眼底病杂志, 2016, 32(3): 283-286. DOI: 10.3760/cma.j.issn.1005-1015.2016.03.013.Li JJ, Li H, Wang P. Comparative observation of choroidal osteoma by multimodal fundus imaging methods[J]. Chin J Ocul Fundus Dis, 2016, 32(3): 283-286. DOI: 10.3760/cma.j.issn.1005-1015.2016.03.013.
9. Hayashi Y, Mitamura Y, Egawa M, et al. Swept-source optical coherence tomographic findings of choroidal osteoma[J]. Case Rep Ophthalmol, 2014, 5(2): 195-202. DOI: 10.1159/000365184.
10. Yang J, Wang E, Yuan M, et al. Three-dimensional choroidal vascularity index in acute central serous chorioretinopathy using swept-source optical coherence tomography[J]. Graefe's Arch Clin Exp Ophthalmol, 2020, 258(2): 241-247. DOI: 10.1007/s00417-019-04524-7.
11. Trimble SN, Schatz H, Schneider GB. Spontaneous decalcification of a choroidal osteoma[J]. Ophthalmology, 1988, 95(5): 631-634. DOI: 10.1016/s0161-6420(88)33144-1.
12. Sisk RA, Riemann CD, Petersen MR, et al. Fundus autofluorescence findings of choroidal osteoma[J]. Retina, 2013, 3(1): 97-104. DOI: 10.1097/IAE.0b013e31825c1cde.
13. Navajas EV, Costa RA, Calucci D, et al. Multimodal fundus imaging in choroidal osteoma[J]. Am J Ophthalmol, 2012, 153(5): 890-895. DOI: 10.1016/j.ajo.2011.10.025.
14. Ide T, Ohguro N, Hayashi A, et al. Optical coherence tomography patterns of choroidal osteoma[J]. Am J Ophthalmol, 2000, 130(1): 131-134. DOI: 10.1016/s0002-9394(00)00503-1.
15. Freton A, Finger PT. Spectral domain-optical coherence tomography analysis of choroidal osteoma[J]. Br J Ophthalmol, 2012, 96(2): 224-228. DOI: 10.1136/bjo.2011.202408.
16. Pellegrini M, Invernizzi A, Giani A, et al. Enhanced depth imaging optical coherence tomography features of choroidal osteoma[J]. Retina, 2014, 34(5): 958-963. DOI: 10.1097/iae.0000000000000017.
17. Williams AT, Font RL, Van Dyk HJ, et al. Osseous choristoma of the choroid simulating a choroidal melanoma: association with a positive 32P test[J]. Arch Ophthalmol, 1978, 96(10): 1874-1877. DOI: 10.1001/archopht.1978.03910060378017.
18. Haruta M, Hangai M, Taguchi C, et al. Spectral-domain optical coherence tomography of the choroid in choroidal osteoma[J]. Ophthalmic Surg Lasers Imaging, 2011, 42: 118-121. DOI: 10.3928/15428877-20111201-04.
19. Shields CL, Arepalli S, Atalay HT, et al. Choroidal osteoma shows bone lamella and vascular channels on enhanced depth imaging optical coherence tomography in 15 eyes[J]. Retina, 2015, 35(4): 750-757. DOI: 10.1097/iae.0000000000000376.
20. Zweifel SA, Engelbert M, Laud K, et al. Outer retinal tubulation: a novel optical coherence tomography finding[J]. Arch Ophthalmol, 2009, 127(12): 1596-1602. DOI: 10.1001/archophthalmol.2009.326.
21. Xuan Y, Zhang Y, Wang M, et al. Multimodal fundus imaging of outer retinal tubulations in choriodal osteoma patients[J]. Retina, 2018, 38(1): 49-59. DOI: 10.1097/iae.0000000000001498.
22. Hariri A, Nittala MG, Sadda SR. Outer retinal tubulation as a predictor of the enlargement amount of geographic atrophy in age-related macular degeneration[J]. Ophthalmology, 2015, 122(2): 407-413. DOI: 10.1016/j.ophtha.2014.08.035.

Previous Article
Expression and significance of SOX11 in retinoblastoma
Next Article
Clinical features of uveal metastases from lung carcinoma

Chinese Journal of Ocular Fundus Diseases

Swept-source optical coherence tomography analysis of choroidal osteoma

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content