International Journal of Clinical & Medical Images

Clinical-Medical Image

A 27-year-old gentleman was referred to Ophthalmology services by his new optometrist following a routine eye test with an unusual looking lesion adjacent to his right optic disk. He was known to have Tuberous Sclerosis Complex (TSC) since childhood. His visual acuities were excellent at 20/20 on Snellen chart in both eyes. Fundus examination of his left eye was normal whilst his right eye showed a solitary, well circumscribed, multi-nodular, opaque lesion just nasal to the right optic disk (Panel A) (Figure 1). On auto fluorescence imaging (Panel B) (Figure 1), a ‘mulberry’ appearance became more apparent, in keeping with a retinal astrocytic hamartoma (RAH) which is most commonly associated with TSC but can also be seen in other conditions such as neurofibromatosis type 1 [1]. It is important to identify a typical RAH and recognise that it is normally an asymptomatic lesion and unlikely to progress. We are reviewing the patient in 6 months’ time as we do not have any old fundus photographs for comparison and will plan for discharge if the lesion remains unchanged.

Keywords: Ophthalmology; Fluorescence imaging.

Declaration of Interests

Both authors have no conflicts of interest to disclose.

References

[1] Destro M, D’amico DJ, Gragoudas ES, Brockhurst RJ, Pinnolis, MK, et al. (1991) Retinal manifestations of neurofibromatosis: Diagnosis and management. Arch Ophthalmol 109: 662-666