Hamartoma simple congenital of retina, with OCT and ultrasonorography evaluation

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