Rajan Gupta1, Rajeev R Pappuru1, K Adrian T Fung2, Marco Lupidi3, Swathi Kaliki4, Lawrence Yannuzzi5, K Bailey Freund5, Kate Reid6, Dinah Zur7, Matias Iglicki8, Jay Chhablani9. 1. Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L. V. Prasad Eye Institute, Hyderabad, India. 2. Westmead Hospital, New South Wales, Sydney, Australia; Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia; Save Sight Institute, University of Sydney, Sydney, Australia. 3. Section of Ophthalmology, Department of Biomedical and Surgical Sciences, University of Perugia, S. Maria della Misericordia Hospital, Perugia, Italy. 4. The Operation Eyesight Universal Institute for Eye Cancer, L. V. Prasad Eye Institute, Hyderabad, India. 5. LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, New York; Department of Ophthalmology, New York University, New York, New York; Vitreous Retina Macula Consultants of New York, New York, New York. 6. Department of Ophthalmology, Canberra Hospital, Canberra, Australia; School of Clinical Medicine, Australian National University, Canberra, Australia. 7. Ophthalmology Division, Tel Aviv-Sourasky Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 8. Private Retina Practice, and University of Buenos Aires, Buenos Aires, Argentina. 9. Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L. V. Prasad Eye Institute, Hyderabad, India. Electronic address: jay.chhablani@gmail.com.
Abstract
PURPOSE: To evaluate the vascular structure within combined hamartoma of retina and retinal pigment epithelium (CHRRPE) lesions using OCT angiography (OCTA). DESIGN: Multicenter, retrospective, observational analysis, PARTICIPANTS: Twenty eyes of patients diagnosed with CHRRPE. METHODS: Retrospective analysis of color fundus photographs, OCT, and OCTA of 20 eyes with CHRRPE. Morphologic characteristics of CHRRPE and the OCT features were correlated with the density of the filigree vascular pattern and with the published histopathologic findings of CHRRPE lesions. MAIN OUTCOME MEASURE: Density of flow signals, that is, the filigree vascular pattern seen on OCTA in the deep capillary plexus, graded as high (>20), intermediate (10-20), or low (<10). RESULTS: Of 20 lesions, 11 were peripapillary, 8 were macular, and 1 was equatorial in location. A high density of filigree vascular pattern was observed in most peripapillary CHRRPE lesions, which also showed full-thickness retinal involvement (8/10). A low density of filigree pattern was seen in macular lesions, which showed partial-thickness retinal involvement and preretinal fibrosis (5/6). CONCLUSIONS: A filigree vascular pattern on OCTA is seen in CHRRPE lesions. High density of this pattern is noted in CHRRPE lesions with a peripapillary location, full-thickness retinal disorganization, and minimal preretinal fibrosis. These findings correlate well with published histopathologic findings of CHRRPE lesions both in terms of topographic and morphologic features. OCT angiography provides a promising method for further study of these lesions.
PURPOSE: To evaluate the vascular structure within combined hamartoma of retina and retinal pigment epithelium (CHRRPE) lesions using OCT angiography (OCTA). DESIGN: Multicenter, retrospective, observational analysis, PARTICIPANTS: Twenty eyes of patients diagnosed with CHRRPE. METHODS: Retrospective analysis of color fundus photographs, OCT, and OCTA of 20 eyes with CHRRPE. Morphologic characteristics of CHRRPE and the OCT features were correlated with the density of the filigree vascular pattern and with the published histopathologic findings of CHRRPE lesions. MAIN OUTCOME MEASURE: Density of flow signals, that is, the filigree vascular pattern seen on OCTA in the deep capillary plexus, graded as high (>20), intermediate (10-20), or low (<10). RESULTS: Of 20 lesions, 11 were peripapillary, 8 were macular, and 1 was equatorial in location. A high density of filigree vascular pattern was observed in most peripapillary CHRRPE lesions, which also showed full-thickness retinal involvement (8/10). A low density of filigree pattern was seen in macular lesions, which showed partial-thickness retinal involvement and preretinal fibrosis (5/6). CONCLUSIONS: A filigree vascular pattern on OCTA is seen in CHRRPE lesions. High density of this pattern is noted in CHRRPE lesions with a peripapillary location, full-thickness retinal disorganization, and minimal preretinal fibrosis. These findings correlate well with published histopathologic findings of CHRRPE lesions both in terms of topographic and morphologic features. OCT angiography provides a promising method for further study of these lesions.
Authors: Thomas A Lazzarini; Hasenin Al-Khersan; Nimesh A Patel; Jonathan F Russell; Kenneth C Fan; Giselle De Oliveira; Catherin I Negron; Elias Mavrofrides; Audina M Berrocal Journal: Am J Ophthalmol Case Rep Date: 2020-10-01