Epiretinal membrane associated with combined hamartoma of retina pigment epithelium: Surgical outcome and histopathological features

Combined hamartoma of the retina and retinal pigment epithelium (CHR-RPE) represents a rare, benign congenital anomaly typically presenting as slightly elevated, variably pigmented lesions. This report details the surgical outcome and histopathological features of an epiretinal membrane associated with CHR-RPE. A 29-year-old woman with a three-year history of gradual visual decline in her right eye underwent a comprehensive ophthalmologic examination, including spectral domain optical coherence tomography (SD-OCT), which revealed characteristic features of CHR-RPE and an overlying epiretinal membrane. She subsequently elected to undergo pars plana vitrectomy with membrane peeling. Intraoperative findings confirmed the presence of histological elements consistent with the internal limiting membrane, fibrillar collagen, vitreous, and cells positive for glial fibrillary acidic protein (GFAP), indicative of glial cells. Postoperatively, there was a noticeable improvement in the retinal architecture; however, visual acuity improvement was minimal. Histopathological analysis of the excised membrane provided insight into the lesion’s cellular composition. This case underscores the complex nature of CHR-RPE associated with epiretinal membranes and the challenges in achieving significant visual acuity improvement despite successful surgical intervention. It highlights the importance of early detection and a personalized approach to management. Future research should focus on optimizing treatment strategies and improving understanding of the prognosis for similar cases.