The authors describe the use of high-definition optical coherence tomography (HD-OCT) in a case of congenital hypertrophy of the retinal pigment epithelium. A 40-year-old woman presented with a large flat pigmented lesion in the inferior retinal quadrant of the left eye, which was compatible with congenital hypertrophy of the retinal pigment epithelium. The lesion was studied with HD-OCT (5 line raster and macular cube 512 × 128) and the results were compared with those of the fellow eye. The volume of the cube in the normal eye measured 7.1 mm(3), whereas the volume of the cube with the lesion was 6.7 mm(3). The subfield thickness analysis was 153 μm in the eye with congenital hypertrophy of the retinal pigment epithelium and 188 μm in the fellow eye, showing a difference of 35 μm between the two eyes. Congenital hypertrophy of the retinal pigment epithelium studied with HD-OCT showed loss of the junction layer between the inner and outer segment of photoreceptors and of the outer nuclear layer.
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