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Case Reports
. 2016 Nov 11;16(1):200.
doi: 10.1186/s12886-016-0377-z.

Macular Telangiectasia Type 2 Accompanied by Solitary Retinal Astrocytic Hamartoma (Case Report)

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Free PMC article
Case Reports

Macular Telangiectasia Type 2 Accompanied by Solitary Retinal Astrocytic Hamartoma (Case Report)

Martin Pencak et al. BMC Ophthalmol. .
Free PMC article

Abstract

Background: To present a coincidence of macular telangiectasia type 2 and solitary retinal astrocytic hamartoma in one patient.

Case presentation: A 50-year-old woman was examined in the Department of Ophthalmology of University hospital Kralovske Vinohrady for complaints of metamorphopsia in her left eye. Her uncorrected visual acuity (VA) was 4/4 on Early Treatment Diabetic Retinopathy Study charts (ETDRS), on the retina of her left eye white, prominent, partially calcified tumour 1 disc diameter in diameter, 1,5 disc diameter from the foveola was detected on the retina. In the macular region of both eyes, parafoveal greying with crystalline deposits and changes in retinal vasculature were visible. We performed following examinations: fluorescein angiography (FA), B-scan ultrasound, spectral domain optical coherence tomography (SD-OCT) including photo documentation. FA showed partial hyperfluorescence of mulberry-like surface of the tumour typical for retinal astrocytic hamartoma. Parafoveally in both eyes, leakage from parafoveal telangiectasia was apparent. SD-OCT showed cystoid space in the macular region of both eyes as well as changes in inner and outer photoreceptor segment junction in left eye. SD-OCT of the tumour showed proliferation in retinal nerve fibre layer with normal structure of underlying retinal layers and choroid. Ultrasound examination of the tumour detected solid, highly echogenic prominent tumour with high reflectivity and acoustic shadow.

Conclusion: A coincidence of two relatively rare clinical units, macular telangiectasia type 2 and solitary astrocytic hamartoma was detected as a unique and rare observation.

Keywords: Astrocytic hamartoma; Case report; Fluorescein angiography (FA); Macular telangiectasia type 2; Optical coherence tomography (SD-OCT).

Figures

Fig. 1
Fig. 1
Colour fundus photography (a). Whitish tumour with calcification at the centre in the upper temporal region of the left eye. Retinal greying with small crystalline deposits and impaired structure of the capillary network with small telangiectasias in temporal parafoveolar region of both eyes. All changes are better visible in red-free documentation of the fundus (b)
Fig. 2
Fig. 2
Hypoautofluorescence at the lesion site with hyperautofluorescence of the central calcification in the left eye. Mild increase in autofluorescence in macular regions of both eyes
Fig. 3
Fig. 3
Late phase FA – leakage from parafoveolar telangiectasias in the macula, leakage in the tumour area in the left eye, with accentuation of the mulberry-like structure of the tumour
Fig. 4
Fig. 4
OCT at the tumour site in the left eye – proliferation in the retinal nerve fibre layer with normal structure of deeper layers of the retina and normal choroidea; a shadow at the calcification site
Fig. 5
Fig. 5
OCT of the macula of the right (a) and left (b) eye – slight cystic infiltration in both eyes and areas of impairment of retinal architecture at the junction of external and internal photoreceptor segments in the left eye
Fig. 6
Fig. 6
Ultrasound of the left eye – solid, highly echogenic, prominent lesion with high reflectivity and an indicated acoustic shadow

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