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.

Design

Retrospective case series.

Methods

Patients diagnosed at tertiary high-volume hospitals between January 2000 and December 2020 were evaluated. The primary outcome measure was visual acuity at 5-year follow-up. The secondary outcome measures included factors associated with favorable vision, defined as loss of <1 line and >20/200 vision.

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 hemorrhage 30%). Although there was significant vision loss by 5 years (P = .002), 12 eyes (44%) had favorable outcomes. 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 predictive 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).

Conclusions

Among patients with choroidal osteoma undergoing anti-VEGF therapy, a particular patient subset presented with divergent outcomes with very poor vision. Tumor thickness appeared to be the differentiating factor and is thus a potential prognostic indicator for long-term visual prognoses.

中文翻译：

---

预测抗血管内皮生长因子治疗脉络膜骨瘤的视力结果

目的

确定与接受抗血管内皮生长因子 (VEGF) 治疗的脉络膜骨瘤患者的长期视力预后相关的潜在因素。

设计

回顾性病例系列。

方法

对 2000 年 1 月至 2020 年 12 月期间在三级大医院确诊的患者进行了评估。主要结果指标是 5 年随访时的视力。次要结果指标包括与良好视力相关的因素，定义为视力丧失 <1 线和视力 >20/200。

结果

在 36 名患有脉络膜骨瘤的患者（22 名女性，61%；平均年龄 38 岁）的 38 只眼中，23 只眼（61%）接受了抗 VEGF 治疗（贝伐珠单抗 1.25mg/0.05cc，每月或治疗-延长）和65% 完成了 5 年的随访。所有接受治疗的眼睛都有相关的脉络膜视网膜合并症（视网膜下积液 91%；脉络膜新生血管 74%；视网膜下出血 30%）。尽管 5 年视力明显下降 ( P  = .002)，但 12 只眼 (44%) 的结果良好。只有肿瘤厚度与不利的视力结果显着相关（OR 917.1，95% CI 1.0-5687.7；P  = .049）。预测视力结果的最佳截止点为 1.4 mm，肿瘤厚度 ≥ 1.4 mm 与不良视力相关（OR 27.0，95% CI 2.0-368.4；P =.013）。

结论

在接受抗 VEGF 治疗的脉络膜骨瘤患者中，特定的患者亚群表现出视力非常差的不同结果。肿瘤厚度似乎是区分因素，因此是长期视觉预后的潜在预后指标。