Ren Q, Han N, Zhang R, Chen RF, Yu P. Combined hamartoma of the retina and retinal pigment epithelium: A case report. World J Clin Cases 2023; 11(8): 1788-1793 [PMID: 36970010 DOI: 10.12998/wjcc.v11.i8.1788]
Corresponding Author of This Article
Peng Yu, Doctor, Deputy Director, Department of Ophthalmology, The Second Hospital of Jilin University, No. 4026 Yatai Street, Nanguan District, Changchun 130022, Jilin Province, China. ypeng@jlu.edu.cn
Research Domain of This Article
Ophthalmology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Mar 16, 2023; 11(8): 1788-1793 Published online Mar 16, 2023. doi: 10.12998/wjcc.v11.i8.1788
Combined hamartoma of the retina and retinal pigment epithelium: A case report
Qing Ren, Ning Han, Rui Zhang, Ruo-Fan Chen, Peng Yu
Qing Ren, Ning Han, Rui Zhang, Ruo-Fan Chen, Peng Yu, Department of Ophthalmology, The Second Hospital of Jilin University, Changchun 130022, Jilin Province, China
Author contributions: Han N provided patient information and operated on him; Yu P designed the study; Zhang R and Chen RF collected the examination information; Ren Q wrote the manuscript and revised it as required.
Informed consent statement: Written informed consent was obtained from the patient’s for publication of this case report.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Peng Yu, Doctor, Deputy Director, Department of Ophthalmology, The Second Hospital of Jilin University, No. 4026 Yatai Street, Nanguan District, Changchun 130022, Jilin Province, China. ypeng@jlu.edu.cn
Received: October 22, 2022 Peer-review started: October 22, 2022 First decision: January 3, 2023 Revised: January 19, 2023 Accepted: February 21, 2023 Article in press: February 21, 2023 Published online: March 16, 2023
Abstract
BACKGROUND
Combined hamartoma of the retina and retinal pigment epithelium (CHRRPE) is a rare congenital benign tumor which is commonly monocular. Typical CHRRPE comprises slightly raised lesions at the posterior pole, with proliferation membrane often leading to vascular distortion. In severe cases, macular edema, macular hole, retinal detachment or vitreous hemorrhage may occur. Patients with atypical clinical manifestations are prone to misdiagnosis by inexperienced ophthalmologists.
CASE SUMMARY
A 33-year-old man reported onset of right eye blurred vision for one week prior. Anterior segment and intraocular pressure were normal in both eyes. Left eye fundus photography was normal. Right eye ophthalmoscopy showed vitreous hemorrhage and off-white raised retinal lesions below the optic disc. Proliferative membranes on the lesion surfaces resulted in superficial retinal detachment and tortuosity and occlusion of peripheral blood vessels. A horseshoe-like tear in the temporal periphery was surrounded by retinal detachment. Optical coherence tomography revealed retinal thickening at the focal site with structural disturbance indicated by high reflectance. Right eye ultrasound showed retinal thickening at the lesion, stretching and uplifting of the proliferative membrane, with moderately patchy echo at the optic disc edge. Cytokines and antibodies were detected in vitreous fluids during the operation to rule out other diseases. Fundus fluorescein angiography (FFA) at postoperative follow-up led to final diagnosis of CHRRPE.
CONCLUSION
FFA is helpful in diagnosing retinal and retinal pigment epithelial combined hamartoma. In addition, other cytokine and etiological tests facilitate further differential diagnosis to rule out other suspected diseases.
Core Tip: Combined hamartoma of the retina and retinal pigment epithelium(CHRRPE) is a rare benign retinal tumor, especially in atypical cases with vitreous hemorrhage and retinal hole, and is likely to be misdiagnosed by inexperienced young doctors. Fundus fluorescein angiography is instructive when diagnosis is difficult, and some etiological tests can also help to identify other inflammatory diseases. This article provides an example of diagnosis to aid young doctors’ reflection and learning.
