Multimodal imaging of two morphological variants of retinal astrocytic hamartoma: An unusual presentation

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A 20-year-old female with an established case of Tuberous sclerosis complex was incidentally found to have retinal astrocytic hamartomas (RAH) in her right eye. Two lesions situated adjacently at the inferior disc margin were detected. The temporal lesion had a smooth, elevated, semitransparent appearance typical of type-1 RAH.[1,2] The other lesion looked saucer-shaped with mulberry-like opaque clumps at its border and an empty core, partially resembling a type-2 RAH. A typical type-2 RAH has a uniform multinodular appearance due to the associated calcification.[1,2] Multimodal imaging [Fig. 1] was done after obtaining informed consent.Figure 1: Multimodal imaging (Color photo – CP, Multicolor image – MCI, Near-infrared image – NIR image, Optical coherence tomography – OCT) demonstrating the distinguishing features of two types of retinal astrocytic hamartomas (RAH). (a) CP showing semi-translucent type-1 and mulberry-like type-2 RAH. (b) MCI with green shift better delineates superficial type-1 RAH. (c) NIR image highlights calcified spherules in type-2 RAH. (d) OCT showing dome-shaped hyperreflective type-1 RAH and moth-eaten appearance of type-2 RAHConclusion Multimodal imaging is useful in distinguishing the morphological variants of RAH. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship: Nil. Conflicts of interest: There are no conflicts of interest.

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