Retinal pigment epithelial alterations leading factor in tumor growth

Patients with ocular tumors tend to have poor visual acuity, and patients with decalcified subfoveal choroidal osteoma have a particularly poor visual prognosis, according to results of a long-term study.

Carol L. Shields, MD, and colleagues at Wills Eye Hospital in Philadelphia evaluated 74 eyes of 61 patients with choroidal osteoma to determine tumor growth rates, tumor decalcification, related choroidal neovascularization, visual acuity loss and the effect on visual acuity. All patients were seen between 1977 and 2003.

At 5 years, tumor growth occurred in 22% of the patients, which increased to 51% by the 10-year follow-up. Tumor decalcification occurred in 28% of the patients at year 5 and in 46% at year 10. CNV remained steady at 31% at both follow-up periods. Loss of visual acuity occurred in 26% of the patients at year 5 and increased to 45% by year 10. Poor visual acuity occurred in 45% of the eyes after 5 years and increased to 56% of the eyes by 10 years.

“The clinical factor predictive of tumor growth was absent overlying retinal pigment epithelial alterations,” the authors said. An irregular tumor surface caused most decalcification. If tumors were partially decalcified at baseline, further tumor growth did not occur. Irregular tumor surfaces and subretinal hemorrhage were factors predictive of CNV.

The study is published in the December issue of Archives of Ophthalmology.