Purpose: To describe the principle characteristics of combined hamartoma of the retina and retinal pigment epithelium ('combined harmatoma') on MultiColorTM imaging and evaluate its role as a diagnostic and management tool.
Methods: Retrospective, observational case series comprising three patients with unilateral, juxtapapillary combined harmatoma. Complete ophthalmic examination was performed. MultiColorTM, including green reflectance (GR) and near infra-red reflectance (NIRR), optical coherence tomography (OCT) and autofluorescence (AF) imaging were obtained (Heidelberg Spectralis).
Results: On MultiColorTM, 'red shifting', indicated partial pigmentation. GR clearly defined epiretinal gliosis, retinal dragging and striations. On NIRR, all lesions were hypo-reflectant with hyper-reflectance at their edges. OCT showed full-thickness retinal thickening and disorganisation, intra-retinal fluid in two cases, sectoral RPE atrophy with photoreceptor loss in one case, RPE thickening and foveal pigment migration in one case; epiretinal membrane associated with 'mini peaks' of the inner retina in all cases and vitreous traction causing retinoschisis in one case. All lesions were hypo-autofluorescent.
Conclusions: MultiColorTM enables combined harmatomas to be further characterised and may represent a valuable diagnostic and management tool: MultiColorTM and NIR define tumour boundaries and macular involvement, which may be useful for assessing visual impact; GR highlights inner retinal distortion, which may aid surgical management decisions.