Surgical Management of Epiretinal Membrane in Combined Hamartomas of the Retina and Retinal Pigment Epithelium

PURPOSE: The purpose of this study was to evaluate the surgical outcome of combined hamartomas of the retina and retinal pigment epithelium in five patients. METHODS: In this interventional retrospective case series study, five patients with combined hamartomas of the retina and retinal pigment epithelium received vitrectomy and epiretinal component peeling. Pre- and postoperative best-corrected visual acuity, fundus examination, photography and fundus fluorescein angiography, optical coherence tomography, and B-ultrasound scan examination were analyzed. RESULTS: The 5 patients were all men, ranging in age from 6 years to 21 years (mean 12.6 +/- 6.5 years). The lesions were unilateral. Preoperative best-corrected visual acuity ranged from 20/340 to 20/50 (median 20/200), and postoperative best-corrected visual acuity ranged from 20/340 to 20/30 (median 20/100). Best-corrected visual acuity improved in 3 patients (60%) after the surgeries and remained unchanged in 2 patients. Epiretinal components were completely removed, except for a small residual membrane left in two cases. Tortuosity of the retinal vessels improved in all the cases after the surgeries. Fundus fluorescein angiography showed reduction in vascular tortuosity and decrease of dye leakage. Optical coherence tomography demonstrated disappearance or reduction of high reflectivity of the inner retina and decrease of underlying retina edema. In two cases, the only complication was temporary ocular hypertension. CONCLUSION: Selected patients with combined hamartomas of the retina and retinal pigment epithelium may benefit from surgical management at the appropriate time.