Combined hamartoma of the retina and retinal pigment epithelium. Anti-VEGF treatment of the associated choroidal neovascular membranes

Abstract

Case report

A 58-year-old female was diagnosed with a juxtapapillary combined hamartoma of the retina and retinal pigment epithelium (CHR–RPE) in her left eye 14 years ago. Her visual acuity in that eye was 20/20. Recently, she came to our department with a sudden visual loss and metamorphopsia in her left eye. After performing funduscopy, angiography and OCT, she was diagnosed with choroidal neovascular membrane (CNVM) at lesion border, and started on antiangiogenic therapy.

Discussion

CHR–RPE, despite being a benign condition, may become complicated with severe visual impairment. Antiangiogenic therapy provides a good alternative to photodynamic therapy or laser photocoagulation for treatment of CNVM, avoiding adding iatrogenesis from these treatments to the complications associated with this pathology.

Resumen

Caso clínico

Paciente de 58 años diagnosticada de hamartoma combinado del epitelio pigmentario retiniano (CHRRPE) yuxtapapilar unilateral en ojo izquierdo hace 14 años, con máxima agudeza visual. Acude con pérdida de visión brusca y metamorfopsias en dicho ojo. Tras funduscopia, angiografía y OCT se diagnostica membrana neovascular coroidea (MNVC) en el borde de la lesión, y se inicia terapia antiangiogénica.

Discusión

El CHRRPE, aunque benigno, puede complicarse produciendo gran deterioro visual. Los antiangiogénicos son buena opción frente a terapia fotodinámica o a fotocoagulación láser para tratar las MNVC, evitando sumar la iatrogenia del tratamiento a complicaciones propias de la patología.