Case report of astrocytic hamartoma associated with tuberous sclerosis

Astrocytic hamartoma is a quite rare disease secondary to tuberous sclerosis and is challenging to identify at the initial ophthalmological examination. The article presents a case report of retinal astrocytic hamartoma secondary to tuberous sclerosis in a 42-year-old male patient. OD ophthalmoscopy revealed a space-occupying, oblong, subretinal, slightly elevated, light yellow lesion of 1.5 disc diameters, with a bumpy surface (resembling a mulberry) at 4–5 o’clock along the inferior nasal vascular arcade. In the left eye, a space-occupying, subretinal, light yellow lesion of 1.5 disc diameters resembling a mulberry was visualized along the superior vascular arcade. A subretinal, flat, gray lesion of about 1.5 disc diameters was observed along the inferior nasal arcade. Magnetic resonance imaging showed multiple lesions (tubers) of altered magnetic resonance signal intensity in the middle cranial fossa, which were typical for tuberous sclerosis. Age of onset, clinical manifestations, and location of tubers in the presented case report are quite consistent with the published data. The presented case report demonstrated challenges of determining etiology of astrocytic hamartoma diagnosed at initial ophthalmological examination.