1/7. Midperipheral mottling pigmentation with familial choroidal osteoma.PURPOSE: To describe a rare presentation of familial choroidal osteoma in two siblings. methods: The clinical findings in two siblings over 4 years' follow-up. RESULTS: Two brothers (15 and 12 years old) had bilateral choroidal osteomas. Both had bilateral peripapillary yellowish-white lesions and midperipheral mottling pigment appearance, which are not seen in sporadic cases. Extensive midperipheral area with mottling pigment appearance was noted by fluorescein angiography (FA) as scattered multiple hyperfluorescent dots. The yellowish-white lesions showed diffuse hyperfluorescence with FA and hypofluorescence with indocyanine green angiography (ICG). ICG also revealed irregular hyperfluorescent areas within the tumor, indicating abnormal choroidal vessels on the tumor. In the left eye of the younger brother, the subretinal fibrosis due to choroidal neovascularization superior to the macula extended down toward the foveal region over 2 years, resulting in visual deterioration. CONCLUSION: The midperipheral mottling pigment appearance of familial choroidal osteoma cases is unique and different from most sporadic cases, suggesting that familial choroidal osteoma might have separate etiologic or modified factors.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/7. Multiple intracranial subarachnoid osteomas.OBJECTIVE AND IMPORTANCE: Intracranial osteomas, which have no connections with the dura or the skull, are very rare. Here we report one case of multiple intracranial subarachnoid osteomas. CLINICAL DESCRIPTION: A 24-year-old gentleman, who had no previous history of systemic disease, meningitis or head injury, presented with a 6-month history of non-specific intermittent headache over the whole head. Neuro-imaging showed multiple ossified lesions in the right frontal area, which were found to compress the underlying cerebral hemisphere. The patient underwent a right frontal craniotomy. The masses were dissected from the depressed brain along the intact pial planes, however, all of the white bone-hard masses tightly adhered to the superficial cortical veins. The masses were removed and the cortical veins were sacrificed. The patient had headaches and was nauseous for three days after the surgery due to venous congestion; however, the patient was neurologically intact on discharge. Pathological diagnosis was osteoma. CONCLUSION: To our knowledge, this is the first report of multiple intracranial subarachnoid osteomas. Surgical findings strongly support the hypothesis of the origin of the tumour that the primitive mesenchymal cells from the connective tissue might have migrated into the subarachnoid space accompanying the intracerebral blood vessels.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/7. Choroidal osteoma: evidence of progression and decalcification over 20 years.Choroidal osteoma is a rare, benign, ossifying tumour of the choroid of unknown aetiology. In contrast to other types of intraocular ossification, choroidal osteoma is found typically in young healthy females in the second or third decades of life with no history of systemic or ocular disease. Choroidal osteoma is a deep, pale yellow lesion with distinct geographic borders at the juxtapapillary or macular region, with branching 'spider' vessels on the surface of the tumour. These features should help differentiate choroidal osteoma from other types of intraocular tumour and the diagnosis can be confirmed with ultrasonography and computerised tomography. Here we report an initially unilateral case of choroidal osteoma, which decalcified over 20 years but during the same period the fellow eye also developed a choroidal osteoma to become a bilateral case. Despite the benign nature of the tumour, vision may be compromised by gradual atrophy of the overlying retina, serous retinal detachment, accumulation of sub-retinal fluid and sub-retinal haemorrhage associated with choroidal neovascularisation. Frequent examinations are recommended for patients with choroidal osteoma, for early detection of a subretinal neovascular membrane and potential treatment with laser photocoagulation.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/7. vascular patency of fibular free graft: assessment by Doppler color-flow imager: a case report.Viability of a vascularized free fibula transfer can be difficult to establish. It is possible, however, to assess patency of the involved microvascular anastomoses and blood flow in the vessels of the transposed fibula. A Doppler color-flow imager can be used to evaluate blood flow and vascular patency. The imager potentially can be employed in the operating room, during the immediate postoperative period, and for long term follow-up. It is non-invasive and produces a permanent record of vascular anatomy and flow characteristics.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/7. Bilateral choroidal osteoma with subretinal neovascularization.Choroidal osteoma is a rare entity, reported previously mainly in females. We report a case of bilateral choroidal osteoma in a 15-year-old boy. ultrasonography and computerized tomography findings were key to establishing the diagnosis. During two years' follow-up, there was observable growth in the tumor size. Leakage from subretinal neovascular tufts covering the tumor caused visual deterioration. Photocoagulation of the subretinal new vessels was performed twice, with limited success, but the value of this treatment in choroidal osteomas needs further study.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/7. Vascular modifications within a choroidal osteoma.We report a case of choroidal osteoma followed-up for 7 years. During this lapse of time the choroidal osteoma showed slight enlargement, development of subretinal hemorrhage and modifications of intratumoral vascularization. Some large intratumoral vessels visible at first examination disappeared at follow-up, while other vessels not observed before developed. The changes in the vascularization of the choroidal osteoma denote profound dynamics in the processes of osseous rearrangement of the tumor.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
7/7. indocyanine green angiography in choroidal osteoma.BACKGROUND: Choroidal osteoma is a rare choroidal tumor; knowledge of its indocyanine green characteristics is limited. methods: The fundus photographs and the fluorescein and indocyanine green angiograms of three patients were reviewed. Each patient was examined at least twice with a follow-up varying from 10 to 60 months. RESULTS: Late-phase fluorescein angiograms allow assessment of the extension of the osteoma as it is variably hyperfluorescent due to tumor staining combined with a variable degree of overlying retinal pigment epithelial changes. The hypofluorescent area observed in the early phase of the indocyanine green angiogram corresponds with the extent of the osteoma but the borders may be difficult to demarcate. In the late phase of the indocyanine green angiogram, hypofluorescence due to choriocapillaris loss and hyperfluorescence due to leakage from abnormal choroidal vessels are combined. Infrared angiography high-lights abnormal choroidal vessels and vascular spiders present on the tumor surface. It is difficult to differentiate these choroidal vascular anomalies from subretinal neovascularization. CONCLUSIONS: We find no homogeneous pattern either on fluorescein or on infrared angiography. The findings may change with follow-up, indicating changes within the tumor or the surrounding tissue that are still poorly understood.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |