Hamartoma simple congenital of retina, with OCT and ultrasonorography evaluation

L. Abad, Cruz Ruiz Gali Mauro, Carlos E Cury
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Abstract

An 11-year-old girl consulted with her parents and reported that the girl had low vision with her right eye. Her parents reported that the girl did not have trauma to that eye nor had a history of eye inflammation. Snellen’s visual acuity was 20/80 in her right eye and 20/20 in her left eye. In the biomicroscopy, there were no significant alterations, the ocular pressure remained within normal limits (14mmHg in both eyes) and, in the fundoscopy of the right eye, revealed a circumscribed lesion in the paramacular area, with irregular borders, nodular type and dark brown pigmentation affecting the RPE, which presented slight hyperplasia, with an increase in retinal thickness in the lower paramacular area with minimal invasion into the vitreous cavity (Figure 1-retinography). The lesion measured 586 microns of basal dimension and 656 microns of thickness in the OCT. The temporal arches were slightly tractioned to the lesion area with elevation of paramacular retina. There was no atrophy of the RPE at the level of lesion or macular edema or subretinal fluid. Ultrasound showed a nodular mass of high echogenicity in the paramacular area. The OCT revealed a prominent reflectivity of the retinal surface at the level of lesion, with an increase in the local thickness of the retina and slight disorganization of the paramacular RPE, causing an abrupt and complete shading of the optical transmission. The RPE outside the limits of lesion next to the choroid did not present alterations. The vitreous presented adhesion to the borders of lesion, by invasion of it to the vitreous cavity.1–3
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单纯性先天性视网膜错构瘤的OCT及超声评价
一个11岁的女孩咨询了她的父母,并报告说她的右眼视力低下。她的父母报告说,女孩的眼睛没有外伤,也没有眼睛炎症史。Snellen的右眼视力为20/80,左眼视力为20/20。生物显微镜下未见明显改变,眼压维持正常范围(双眼14mmHg),右眼眼底镜检查显示黄斑旁区病变边界分明,边界不规则,结节型,影响RPE的深棕色色素沉着,呈轻度增生,黄斑下黄斑旁区视网膜厚度增加,对玻璃体腔的侵犯最小(图1视网膜造影)。病变基底尺寸586 μ m, oct厚度656 μ m,颞弓轻微牵拉至病变区,伴视网膜旁突升高。在病变或黄斑水肿或视网膜下积液的水平上,RPE没有萎缩。超声显示一高回声的结节状肿块。OCT显示病变水平视网膜表面反射率突出,局部视网膜厚度增加,黄斑旁RPE轻度紊乱,导致光透射突然完全遮挡。病变范围外靠近脉络膜的RPE未见改变。玻璃体因侵入玻璃体腔而与病变边缘粘连
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