Retina Vitreous · Choroidal melanoma

Hamartoma of retina and retinal pigment epithelium

Retinal astrocytic hamartomas (RAH) are benign retinal tumors composed of glial cells. They are typically encountered as an asymptomatic lesion in patients with tuberous sclerosis complex (TSC); however, may be isolated tumors or found in association with other ocular or systemic disease. RAH are diagnosed clinically based on characteristic ophthalmoscopic appearance Classically, three morphological subtypes of RAH have been described.These are: Type 1 (most common): relatively flat, smooth, semitransparent, grey-white lesions without calcification Type 2: raised, multinodular (‘mulberry-like’), opaque, calcified lesions Type 3: transitional lesion with features of Type 1 and Type 2 Lesions typically remain stable with age, and do not evolve between types Spectral-domain (SD) optical coherence tomography (OCT) features of RAH are well described. Tumors are localized in the retinal nerve fiber layer, with dome-shaped thickening and hyperreflectivity present at the inner retina. Characteristic optically empty spaces (‘moth eaten’ areas) are present representing intralesional calcification or cavitation. Outer retinal layers may be compressed or disorganised by the tumor. Calcification and may cause posterior optical shadowing. OCT may also demonstrate CNVM.

Contributed byDr. Sahil KumarResident, Na

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