Later Development of Posterior Staphyloma in Choroidal Osteoma With Choroidal Neovascularization

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A 51-year-old man presented with metamorphopsia in the right eye for 2 weeks. His right vision was counting fingers. Fundoscopic examination demonstrated subretinal macular hemorrhage over a large choroidal osteoma with peripapillary decalcification, especially in superior portion (Figure 1A). Fluorescein angiographic examination showed classic choroidal neovascularization. Time-domain optical coherence tomography showed a highly reflective fibrovascular tissue above the retinal pigment epithelium with subretinal fluid (Figure 1B), which is consistent with subretinal hemorrhage secondary to choroidal neovascularization. He received an intravitreal injection of bevacizumab resulting in choroidal neovascularization regression. His right eye achieved favorable visual outcome of 20/30 in 1 month. However, 7 years later, he experienced rhegmatogenous retinal detachment and vitreous hemorrhage, and received vitrectomy. Postoperatively, fundus examination demonstrated macular staphyloma (Figure 1C). Spectral domain optical coherence tomography showed a large macular choroidal excavation associated with foveoschisis and loss of the ellipsoidal zone and external limiting membrane (Figure 1D). His best-corrected visual acuity was 20/200 in the right eye.
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