Паёми Сино (Sep 2024)
RETINAL ASTROCYTIC HAMARTOMA: CLINICAL FEATURES
Abstract
Objective: To present the clinical features of retinal astrocytic hamartoma (RAH) based on the acquired experience Methods: Medical records were analyzed on 10 patients diagnosed with RAH at the S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia, between 2013 and 2023. The average age of the patients was 16 years (range, 1 month – 32 years). Among these patients were 6 men, 1 woman, and 3 children (1 boy and 2 girls). The patients underwent a comprehensive ophthalmological examination, including visometry, tonometry, perimetry, biomicroscopy, ophthalmoscopy, and B-scan ultrasonography to determine the location and size of the lesion, as well as optical coherence tomography (OCT) for secondary retinal detachment Results: The average visual acuity (VA) of patients at the time of diagnosis was 0.7 (range, 0.16-1.0). VA in young children was assessed by tracking moving objects. All children were able to fixate and actively track the object. Most patients (n=8; 80%) were diagnosed with RAH based on the clinical (ophthalmoscopic) picture of the fundus, ultrasound, and OCT data. The average height of the RAH was 1.7 mm (range, 1.0 to 3.2 mm), and the average length was 4.2 mm (range, 0.4 to 7.6 mm). In all cases, the B-scan results showed lesions with hyperechogenicity of high amplitude. 4 patients displayed common signs – thickening of the neuroepithelium with optically empty spaces with a lobulated, "moth-eaten" appearance on the OCT. In contrast, the remaining patients had a homogeneous hyper-reflective thickening of the neuroepithelium in the lesion area. Two patients (20%) had cystoid macular edema in the fovea and secondary flat detachment of the neuroepithelium extending from the hamartoma to the fovea Conclusion: Differential diagnosis of RAH and retinoblastoma (RB) is crucial because, if misdiagnosed, it leads to unnecessary and aggressive treatment
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