Choroidal osteoma.

Choroidal osteomas are benign, juxtapapillary, choroidal tumors that mandate no treatment. They occur predominantly in young (median age, 20 years) females (90%). While ophthalmoscopy and fluorescein angiography reveal suggestive ophthalmic findings, echography, plain radiography, and especially computed tomography (CT) are important in establishing the correct diagnosis. These lesions may be clinically confused with various dystrophic lesions, atypical or amelanotic malignant choroidal melanoma, metastatic carcinoma, leukemic or lymphomatous infiltrates, choroidal hemangioma, choroidal scars of the macula, and organized subretinal hemorrhage. The exclusion of the differential consideration of malignant melanoma is most important since radiation and enucleation are therapeutic possibilities. Review of the literature shows that all nine reported cases with CT scans had clearly demonstrable calcific densities in the posterior pole of the affected eye. Four other cases are reported here with a summary of the typical clinical, radiologic, and pathologic findings. The role of CT in the evaluation of choroidal osteoma and the distinctiveness of the CT findings are stressed.