Case Report: Faricimab in the treatment of subretinal fluid secondary to choroidal osteoma without definite evidence of CNV.

Background: Choroidal osteoma is a rare benign osseous tumor that most commonly occurs in young women, typically located in the choroid near the optic disc or in the macular region. Secondary choroidal neovascularization (CNV) or subretinal fluid (SRF) is the main causes of visual impairment in affected patients. Case report: This article reports a 36-year-old woman who presented with decreased vision in her right eye. Multimodal imaging confirmed a choroidal osteoma in the right eye complicated by SRF in the macular area. After intravitreal injections of ranibizumab, SRF decreased substantially. Approximately 40 weeks later, the patient reported recurrent visual decline, and macular SRF recurs. After switching to intravitreal injection of faricimab (6 mg/0.05 mL), the SRF resolved completely, macular complete SRF resolution with restoration of the foveal contour, and visual acuity remained stable throughout subsequent follow-up. Conclusion: This case suggests that anti-VEGF therapy may be an option for SRF secondary to choroidal osteoma. In recurrent cases without definite CNV, faricimab may facilitate SRF resolution, though the proposed Ang-2-mediated vascular-stabilizing effect requires further validation.