Delayed presentation of combined hamartoma of the retina and retinal pigment epithelium in the macula

Abstract

Introduction: Combined hamartoma of the retina and retinal pigment epithelium (CHRRPE) is a rare benign tumour of neurosensory retina and retinal pigment epithelium usually found in children. Surgical treatment of epiretinal membrane associated with CHRRPE is still a subject of debate. Methods: A case report. Results: A 7 year old female was referred to our department due to vision loss and changes in the fundus of her right eye. Her last ophthalmic examination was normal one year ago. The referral diagnosis was toxocariasis. Best corrected visual acuity in the right eye was 0.15. A grey solitary tumour with epiretinal membrane, tortuous vessels and traction was found in the macula. Optical coherence tomography (OCT) showed signs of CHRRPE. Pars plana vitrectomy was performed with epiretinal membrane peeling. The macular traction was reduced and visual acuity remained stable after the surgery. Conclusion: CHRRPE can be diagnosed late as children lack of ability to notice vision loss in one eye. OCT is important in differential diagnosis of CHRRPE and follow up for cooperative patients. Surgical treatment of epiretinal membrane associated with CHRRPE is a safe procedure to improve retinal architecture.