MultiColor imaging in combined hamartoma of the retina and retinal pigment epithelium.

PURPOSE

To describe the principle characteristics of combined hamartoma of the retina and retinal pigment epithelium ('combined harmatoma') on MultiColor imaging and evaluate its role as a diagnostic and management tool.

METHODS

Retrospective, observational case series comprising three patients with unilateral, juxtapapillary combined harmatoma. Complete ophthalmic examination was performed. MultiColor, including green reflectance (GR) and near infra-red reflectance (NIRR), optical coherence tomography (OCT) and autofluorescence (AF) imaging were obtained (Heidelberg Spectralis).

RESULTS

On MultiColor, 'red shifting', indicated partial pigmentation. GR clearly defined epiretinal gliosis, retinal dragging and striations. On NIRR, all lesions were hypo-reflectant with hyper-reflectance at their edges. OCT showed full-thickness retinal thickening and disorganisation, intra-retinal fluid in two cases, sectoral RPE atrophy with photoreceptor loss in one case, RPE thickening and foveal pigment migration in one case; epiretinal membrane associated with 'mini peaks' of the inner retina in all cases and vitreous traction causing retinoschisis in one case. All lesions were hypo-autofluorescent.

CONCLUSIONS

MultiColor enables combined harmatomas to be further characterised and may represent a valuable diagnostic and management tool: MultiColor and NIR define tumour boundaries and macular involvement, which may be useful for assessing visual impact; GR highlights inner retinal distortion, which may aid surgical management decisions.