Inhibition of choroidal osteoma progression using bisphosphonate and RANKL-inhibitory treatment
Purpose: To describe the use of anti-osteoclastic medications (i.e., bisphosphonates and receptor activator of nuclear factor kappa beta (RANK) ligand inhibitors) in treating choroidal osteoma. Methods: A 42-year-old male with bilateral posterior choroidal osteomas showed extensive outer retinal atr...
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Elsevier
2024-12-01
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| Series: | American Journal of Ophthalmology Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993624001774 |
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| author | Mélanie Hébert Kelly Babic Edward C. Hsiao Armin Afshar Nisha Acharya John A. Gonzales |
| author_facet | Mélanie Hébert Kelly Babic Edward C. Hsiao Armin Afshar Nisha Acharya John A. Gonzales |
| author_sort | Mélanie Hébert |
| collection | DOAJ |
| description | Purpose: To describe the use of anti-osteoclastic medications (i.e., bisphosphonates and receptor activator of nuclear factor kappa beta (RANK) ligand inhibitors) in treating choroidal osteoma. Methods: A 42-year-old male with bilateral posterior choroidal osteomas showed extensive outer retinal atrophy in the right eye secondary to decalcification of a choroidal osteoma and progressive extension of retinal pigment epithelial atrophy in the left eye encroaching on the macula with subtle changes in the choroidal osteoma. Bisphosphonates (i.e., oral alendronate 70 mg weekly) or RANK ligand inhibitors (i.e., subcutaneous denosumab 60 mg every six months) were initiated to prevent calcium resorption. Results: After the introduction of more directed therapy, there was stabilization of the patient's condition over the next nine years while under bisphosphonate treatment, followed by a switch to RANK ligand inhibitor therapy and later bisphosphonate treatment again. This was made evident through stability in fundus photography, enhanced depth imaging optical coherence tomography, and B-scan ultrasonography regarding outer retinal layers thickness, and choroidal osteoma thickness and calcification. Conclusion: Anti-osteoclastic therapy using bisphosphonates or RANK ligand inhibitors could be a new treatment paradigm to prevent resorption of choroidal osteomas and prevent the subsequent atrophy of outer retinal layers. Summary statement: A patient with bilateral posterior choroidal osteomas was treated with bisphosphonates and RANK ligand inhibitors to prevent osteoma resorption in the better-seeing left eye. This has led to stability over six years of outer retinal layers thickness, choroidal osteoma thickness, and choroidal osteoma calcification. |
| format | Article |
| id | doaj-art-bf63f2f1d4f34bd589f9f48a685d6f1b |
| institution | OA Journals |
| issn | 2451-9936 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj-art-bf63f2f1d4f34bd589f9f48a685d6f1b2025-08-20T01:57:56ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362024-12-013610216710.1016/j.ajoc.2024.102167Inhibition of choroidal osteoma progression using bisphosphonate and RANKL-inhibitory treatmentMélanie Hébert0Kelly Babic1Edward C. Hsiao2Armin Afshar3Nisha Acharya4John A. Gonzales5Department of Ophthalmology, Hôpital du Saint-Sacrement, CHU de Québec – Université Laval, Québec, CanadaDepartment of Ophthalmology, University of California, San Francisco, San Francisco, USADivision of Endocrinology and Metabolism, School of Medicine, University of California, San Francisco, San Francisco, USADepartment of Ophthalmology, University of California, San Francisco, San Francisco, USADepartment of Ophthalmology, University of California, San Francisco, San Francisco, USA; Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, USADepartment of Ophthalmology, University of California, San Francisco, San Francisco, USA; Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, USA; Corresponding author. Francis I. Proctor Foundation, Department of Ophthalmology, University of California, San Francisco, 490 Illinois Street, San Francisco, CA, USA.Purpose: To describe the use of anti-osteoclastic medications (i.e., bisphosphonates and receptor activator of nuclear factor kappa beta (RANK) ligand inhibitors) in treating choroidal osteoma. Methods: A 42-year-old male with bilateral posterior choroidal osteomas showed extensive outer retinal atrophy in the right eye secondary to decalcification of a choroidal osteoma and progressive extension of retinal pigment epithelial atrophy in the left eye encroaching on the macula with subtle changes in the choroidal osteoma. Bisphosphonates (i.e., oral alendronate 70 mg weekly) or RANK ligand inhibitors (i.e., subcutaneous denosumab 60 mg every six months) were initiated to prevent calcium resorption. Results: After the introduction of more directed therapy, there was stabilization of the patient's condition over the next nine years while under bisphosphonate treatment, followed by a switch to RANK ligand inhibitor therapy and later bisphosphonate treatment again. This was made evident through stability in fundus photography, enhanced depth imaging optical coherence tomography, and B-scan ultrasonography regarding outer retinal layers thickness, and choroidal osteoma thickness and calcification. Conclusion: Anti-osteoclastic therapy using bisphosphonates or RANK ligand inhibitors could be a new treatment paradigm to prevent resorption of choroidal osteomas and prevent the subsequent atrophy of outer retinal layers. Summary statement: A patient with bilateral posterior choroidal osteomas was treated with bisphosphonates and RANK ligand inhibitors to prevent osteoma resorption in the better-seeing left eye. This has led to stability over six years of outer retinal layers thickness, choroidal osteoma thickness, and choroidal osteoma calcification.http://www.sciencedirect.com/science/article/pii/S2451993624001774Alphabetic order): bisphosphonatesChoroidal osteomaOsteoclast activityOuter retinal layer thicknessReceptor activator of nuclear factor kappa beta ligand inhibitors |
| spellingShingle | Mélanie Hébert Kelly Babic Edward C. Hsiao Armin Afshar Nisha Acharya John A. Gonzales Inhibition of choroidal osteoma progression using bisphosphonate and RANKL-inhibitory treatment American Journal of Ophthalmology Case Reports Alphabetic order): bisphosphonates Choroidal osteoma Osteoclast activity Outer retinal layer thickness Receptor activator of nuclear factor kappa beta ligand inhibitors |
| title | Inhibition of choroidal osteoma progression using bisphosphonate and RANKL-inhibitory treatment |
| title_full | Inhibition of choroidal osteoma progression using bisphosphonate and RANKL-inhibitory treatment |
| title_fullStr | Inhibition of choroidal osteoma progression using bisphosphonate and RANKL-inhibitory treatment |
| title_full_unstemmed | Inhibition of choroidal osteoma progression using bisphosphonate and RANKL-inhibitory treatment |
| title_short | Inhibition of choroidal osteoma progression using bisphosphonate and RANKL-inhibitory treatment |
| title_sort | inhibition of choroidal osteoma progression using bisphosphonate and rankl inhibitory treatment |
| topic | Alphabetic order): bisphosphonates Choroidal osteoma Osteoclast activity Outer retinal layer thickness Receptor activator of nuclear factor kappa beta ligand inhibitors |
| url | http://www.sciencedirect.com/science/article/pii/S2451993624001774 |
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