The Development of Choroidal Osteoma in an Eye with Punctate Inner Choroidopathy: A Case Report and Review of Literature

Purpose: To report a case of Choroidal osteoma developing in a patient known to have punctate inner choroidopathy (PIC) and to demonstrate the development and progression of the choroidal osteoma (CO) over fifteen years of follow-up. Methods: Retrospective case report and review of the literature. Results: A 44-year-old male who was diagnosed with PIC in both eyes, which was complicated with a choroidal neovascular membrane (CNVM) in the left eye, received systemic treatment, including oral prednisolone and mycophenolate mofetil to treat PIC, and intravitreal injection of anti-vascular endothelial growth factors (Anti-VEGF). Over fifteen years, a progressively enlarging juxta-foveal choroidal osteoma developed, which was confirmed by B-scan ultrasonography and multimodal imaging. Conclusion: The diagnosis of choroidal osteoma in the setting of PIC can be diagnostically challenging, especially at early stages. As both conditions can lead to the development of CNVM, a high index of suspicion is needed to diagnose these cases.