FOR THE MEDICAL PRACTITIONER
Ophthalmology
doi: 10.25005/2074-0581-2024-26-3-461-468
RETINAL ASTROCYTIC HAMARTOMA: CLINICAL FEATURES

A.A. YAROVOY, V.I. MIROSHNIKOV, E.O. MALAKSHINOVA, D.P. VOLODIN, V.A. YAROVAYA

S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation

Objective: To present the clinical features of retinal astrocytic hamartoma (RAH) based on the acquired experience

Methods: Medical records were analyzed on 10 patients diagnosed with RAH at the S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia, between 2013 and 2023. The average age of the patients was 16 years (range, 1 month – 32 years). Among these patients were 6 men, 1 woman, and 3 children (1 boy and 2 girls). The patients underwent a comprehensive ophthalmological examination, including visometry, tonometry, perimetry, biomicroscopy, ophthalmoscopy, and B-scan ultrasonography to determine the location and size of the lesion, as well as optical coherence tomography (OCT) for secondary retinal detachment

Results: The average visual acuity (VA) of patients at the time of diagnosis was 0.7 (range, 0.16-1.0). VA in young children was assessed by tracking moving objects. All children were able to fixate and actively track the object. Most patients (n=8; 80%) were diagnosed with RAH based on the clinical (ophthalmoscopic) picture of the fundus, ultrasound, and OCT data. The average height of the RAH was 1.7 mm (range, 1.0 to 3.2 mm), and the average length was 4.2 mm (range, 0.4 to 7.6 mm). In all cases, the B-scan results showed lesions with hyperechogenicity of high amplitude. 4 patients displayed common signs – thickening of the neuroepithelium with optically empty spaces with a lobulated, "moth-eaten" appearance on the OCT. In contrast, the remaining patients had a homogeneous hyper-reflective thickening of the neuroepithelium in the lesion area. Two patients (20%) had cystoid macular edema in the fovea and secondary flat detachment of the neuroepithelium extending from the hamartoma to the fovea

Conclusion: Differential diagnosis of RAH and retinoblastoma (RB) is crucial because, if misdiagnosed, it leads to unnecessary and aggressive treatment

Keywords: Astrocytic hamartoma, differential diagnosis, clinical features, ultrasound, optical coherence tomography.

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Authors' information:

Yaronoy Andrey Aleksandrovich,
Doctor of Medical Sciences, Head of the Departmnet of Ophthalmooncology and Radiology, S. Fyodorov Eye Microsurgery Federal State Institution
ORCID ID: 0000-0003-2219-7054
SPIN: 9401-4489
E-mail: yarovoyaa@yandex.ru

Miroshnikov Vladimir Igorevich,
Resident Physician, S. Fyodorov Eye Microsurgery Federal State Institution
ORCID ID: 0009-0006-4839-1428
SPIN: 1143-5151
E-mail: vladimir.miroshnikov@icloud.com

Malakshinova Ekaterina Olegovna,
Resident Physician, S. Fyodorov Eye Microsurgery Federal State Institution
ORCID ID: 0009-0009-9022-5249
SPIN: 2272-5994
E-mail: ekaterinamalakshinova@yandex.ru

Volodin Denis Pavlovich,
Ophtalmologist, Postgraduate Student, S. Fyodorov Eye Microsurgery Federal State Institution
ORCID ID: 0000-0002-3660-7803
SPIN: 7404-9620
E-mail: volodin.den2016@yandex.ru

Yarovaya Vera Andreevna,
Candidate of Medical Sciences, Ophtalmologist, Departmnet of Ophthalmooncology and Radiology, S. Fyodorov Eye Microsurgery Federal State Institution
ORCID ID: 0000-0001-8937-7450
SPIN: 4000-0180
E-mail: verandreevna@gmail.com

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Miroshnikov Vladimir Igorevich
Resident Physician, S. Fyodorov Eye Microsurgery Federal State Institution

127486, Russian Federation, Moscow, Beskudnikovskiy Boulevard, 59A

Tel.: +7 (918) 8938693

E-mail: vladimir.miroshnikov@icloud.com


This work is licensed under a Creative Commons Attribution 4.0 International License.

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