Use of Aflibercept to Treat Choroidal Neovascularization Secondary to Choroidal Osteoma in a 7-Year-Old Child: A Multimodal Imaging Case Report.

Purpose: This study is aimed at reporting a case of choroidal osteoma in a young boy complicated by choroidal neovascularization (CNV) and describing its clinical course over 9 months following intravitreal aflibercept injections. Observation: A 7-year-old boy presented with a 2-month history of decreased vision in his left eye. Clinical examination and multimodal imaging revealed a central choroidal osteoma complicated by an active CNV with associated subretinal hemorrhage and fluid. The patient was treated with intravitreal aflibercept under general anesthesia. Follow-up visits demonstrated early anatomical improvement, with resolution of subretinal hemorrhage and fluid. However, recurrent CNV activity and fluctuating visual acuity were observed. Conclusion: Although choroidal osteoma is more commonly reported in adult females, it should also be considered in young boys. Early treatment with aflibercept was associated with short-term anatomical and transient functional improvements in the management of CNV secondary to choroidal osteoma. However, visual acuity fluctuated during follow-up visits, necessitating recurrent CNV injections. Therefore, regular follow-up is essential due to the risk of recurrence and to preserve long-term visual acuity. Given the rarity of this condition, further studies with larger sample sizes and extended follow-up periods are required to evaluate the effectiveness of anti-vascular endothelial growth factor therapy and establish evidence-based management guidelines.