Título

RETINAL SENSITIVITY CORRELATED TO PHOTORECEPTOR ARRANGEMENT CHANGES SECONDARY TO CONGENITAL SIMPLE HAMARTOMA OF RETINAL PIGMENT EPITHELIUM

Introdução / Purpose

Although the congenital simple hamartoma of retinal pigment epithelium is a benign lesion, we described a novel noninvasive imaging assessment that detected potential photoreceptor abnormalities and retinal function interplay.

Material e Método / Methods

We report a 35-year-old woman with asymptomatic, solitary, circumscribed and pigmented lesion in her left eye. The patient underwent comprehensive ophthalmic examination that included a multimodal evaluation: near-infrared reflectance scanning laser ophthalmoscopy, blue autofluorescence, enhanced-depth imaging spectral domain optical coherence tomography, en face Optovue & OCT Angiography and microperimetry plus Adaptive Optics imaging.

Resultados / Results

Ophthalmoscopic examination revealed a juxtafoveolar pigmented lesion with feeding retinal arteriole linked. There was no macular edema, exudation, hemorrhage, traction and subretinal fluid. Multimodal imaging corroborating prior studies, revealing intra-lesion late staining on fluorescein angiography, Near-infrared reflectance imaging intrinsic hyperreflectivity, short-wavelength autofluorescence and redfree filter photography revealed blocked signal by the lesion. Shadowing depth on spectralis B-scan OCT. Remarkably, on Optovue device a detailed B-scan OCT horizontal section architecture and en face findings. In addition, an exclusive ring-shaped vessel circuit on OCT angiography and increased foveal avascular zone. New insights from cell density arrangement and retinal sensitivity.

Discussão e Conclusões / Discussion

These findings suggest that hamartomatous lesion might cause specific cell changes correlated or not to the retina sensitivity response that potentially vary with vasculature nourishment balance and outer retinal layer integrity, despite their lack of malignant.

Palavras Chave

hamartoma, choroid, EPR