Optical Coherence Tomography of Retinal Astrocytic Hamartoma in 15 Cases

Abstract

To describe the features of retinal astrocytic hamartoma using optical coherence tomography (OCT). Retrospective, observational, noncomparative case series. Fifteen consecutive eyes from 14 patients with retinal astrocytic hamartoma. Optical coherence tomography characteristics of the tumor. The mean patient age at OCT was 33 years, and tuberous sclerosis was present in 3 patients (21%). By ophthalmoscopy, the mean basal diameter of the tumor was 3.6 mm. By OCT, the tumor showed hyperreflectivity at its surface, internal retinal disorganization, and a gradual gently sloping transition from a normal retina into a tumorous retina in all 15 cases (100%). By OCT, the retinal disorganization was limited to the inner retina in 3 (20%), outer retina in 0 (0%), full retina in 5 (33%), and inner retina with no view of deeper layers due to shadowing in 7 (47%). On OCT, there was mild retinal traction on the surface of the tumor in 4 (27%), discrete internal moth-eaten optically empty spaces representing intralesional calcification or intratumoral cavities in 10 (67%), and optical shadowing posterior to the tumor in 14 (93%). Other retinal findings on OCT included shallow elevation of the adjacent retina in 2 (13%), adjacent retinal edema in 4 (27%), and macular edema in 3 (20%). Retinal astrocytic hamartoma shows characteristic features on OCT, including a gradual transition from a normal retina into an optically hyperreflective mass with retinal disorganization, characteristic moth-eaten spaces, and posterior shadowing.