case_images: PMC11773265_01
case_images: Color photographs, posterior segment optical coherence tomography (PS-OCT) images, indocyanine green angiography (ICGA) images, fluorescence angiography (FA) images, Ultrasonographic images, and computed tomography (CT) images of bilateral choroidal osteoma. (a, b) Color photographs of the right eye (a) and the left eye (b) showing the yellowish to orange, slightly elevated subretinal lesion (black arrows). (c) Horizontal PS-OCT images of the right eye with subretinal fluid and a mass under retinal pigment epithelium (RPE) (red arrowheads). (d) Vertical PS-OCT images of the left eye with subretinal fluid and a mass under RPE (red arrowheads). (e, f) Early-phase ICGA images of the right eye (e) and the left eye (f) showing partial hypocyanine choroidal circulation (red arrows) and dilated choroidal vortex veins (yellow arrows). (g, h) intermediate-phase FA images of the right eye (g) and the left eye (h) showing hypofluorescent spots (red arrows) and hyperfluorescent spots (yellow arrows). (i, j) Ultrasonographic images of the right eye (i) and the left eye (j) showing hyperechogenic mass at the posterior wall of both eyes with deeper acoustic shadows (yellow arrows). (k) CT showing calcification of the choroid at the posterior wall of both eyes (yellow arrows). (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
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case_images: PMC11773265_01_gr1.jpg
case_images: fig1
case_images: In the fundus, yellowish-to-orange, slightly elevated subretinal lesions were detected superior to the macular and inferotemporal regions of the right eye, and superior to the macular and temporal regions of the left eye. (Fig. 1a and b). Swept-source optical coherence tomography (OCT) (DRI-OCT, Topcon, Tokyo, Japan) revealed a slight SRF in the fovea and a mass under the RPE in the macular area of both eyes (Fig. 1c and d). Fluorescein angiography (FA) revealed hypofluorescent spots under intact retinal vascular perfusion superior to the macular region of the right eye, superior to the macular temporal region of the left eye, and hyperfluorescent window defects in the inferotemporal and temporal regions of the right and left eyes, respectively (Fig. 1g and h). Ultrasonography detected a hyperechogenic mass in the posterior wall of both eyes with deeper acoustic shadows (Fig. 1i and j), and computed tomography (CT) detected calcification of the choroid in the posterior wall of both eyes (Fig. 1k).
case_images: Color photographs and posterior segment optical coherence tomography (PS-OCT) images before and after the subscleral sclerectomy for secondary serous retinal detachment (SRD). (a,b) Color photographs of the left eye before (a) and after (c) the surgery. (c,d) Vertical PS-OCT images of the left eye before (b) and after (d) the surgery. Superior SRD resolved after the surgery. (e,f) Color photographs of the right eye before (e) and after (g) the surgery. (f,h) Horizontal PS-OCT images of the left eye before (a) and after (b) the surgery. SRD at the fovea resolved after the surgery. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
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case_images: PMC11773265_01_gr2.jpg
case_images: fig2
case_images: Indocyanine green angiography (ICGA) demonstrated hypocyanescence superior to the macular and inferior regions of the right eye and superior to the macular and temporal regions of the left eye from the early phase, corresponding close to the mass area under the RPE in OCT and the yellowish-to-orange lesions in the fundus photographs (Fig. 2e and f). Hospital approved the prescription of oral methotrexate for refractory uveitis with written informed consent (Work Order #03-M022). However, the SRF did not decrease but rather increased superior to the macula without any retinal holes or tears in the left eye (Fig. 2a and b), and vision declined to 20/60 in 4 months. One day after surgery, the SRF resolved dramatically (Fig. 2c and d). After two months, the SRF at the fovea increased and vision declined to 20/50 in the right eye (Fig. 2e and f), and subscleral sclerectomy was performed. Four days after surgery, the SRF resolved (Fig. 2g and h).
case_images: Color photographs and posterior segment optical coherence tomography (PS-OCT) images four years after the subscleral sclerectomy. (a,b) Color photographs of the right eye (a) and the left eye (b). (c,d) Horizontal PS-OCT images of the right eye (c) and the left eye (d). (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
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case_images: PMC11773265_01_gr3.jpg
case_images: fig3
case_images: Overall, inflammation was controlled under 7.5 mg/week of oral methotrexate and NSAIDs for 4 years of follow-up with a vision of 20/80 and 20/50 under the cataract (Fig. 3a-d).