Abstract
Combined hamartoma of the retina and retinal pigment epithelium (RPE) is a rare congenital benign lesion. It is most often detected in young adults and adolescents. The disorder is mostly asymptomatic, however, in 24% of patients the loss of visual function results from complications, such as epiretinal fibrosis associated with tractional distortion of the fovea, hemophthalmos, choroidal neovascularization, exudative retinal detachment, macular edema, and combined tractional/rhegmatogenous retinal detachment. Currently, there is no consensus on the combined hamartoma complications management. The reported clinical case demonstrates the feasibility of staged approach to treatment of combined hamartoma of the retina and RPE complicated by epiretinal fibrosis and partial hemophthalmos using the advanced diagnosis (optical coherence tomography) and treatment methods.
Highlights
Eales’ disease is an idiopathic occlusive inflammatory vasculopathy, which results in peripheral retinal ischemia, neovascularization, recurrent hemophthalmos and proliferative tissue formation [1, 2]
The use of “rigid” retinal laser photocoagulation may result in complications, such as exudative retinal detachment, iatrogenic choroidal neovascularization, cystoid macular edema, epiretinal fibrosis, visual field deficits, deterioration in color vision and decline in contrast sensitivity [30,31,32]
3b Eales’ disease and preserved retinal function were confirmed by advanced diagnosis methods: computer perimetry, computer microperimetry, and optical coherence tomography imaging
Summary
Eales’ disease is an idiopathic occlusive inflammatory vasculopathy, which results in peripheral retinal ischemia, neovascularization, recurrent hemophthalmos and proliferative tissue formation [1, 2]. Etiopathogenesis of the Eales’ disease is not completely understood. According to the literary sources, the disorder usually presents with involvement of peripheral retina and is characterized by a number of manifestations of varying intensity: inflamed veins, ischemia and retinal neovascularization. The listed above manifestations often result in the following complications: recurrent retinal and vitreous hemorrhages, traction/rhegmatogenous retinal detachment, rubeosis iridis and secondary glaucoma [8]. The “gold standard” in the Eales’ disease detection is fluorescein angiography (FA) allowing one to assess blood flow and damage to retinal blood vessels: dye transudation, retinal vascular tortuosity and telangiectasia, vascular shunt, venous stasis, ischemia, retinal neovascularization [10,11,12]. Stage 1 (1a) Periphlebitis of small caliber vessels (1b) Periphlebitis of large caliber vessels with superficial retinal hemorrhages
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