PLASMIN-ASSISTED VITRECTOMY FOR BILATERAL COMBINED HAMARTOMA OF THE RETINA AND RETINAL PIGMENT EPITHELIUM: HISTOPATHOLOGY, IMMUNOHISTOCHEMISTRY, AND OPTICAL COHERENCE TOMOGRAPHY

Purpose To report the surgical outcome, histopathology, immunohistochemistry, and optical coherence tomographic findings in a case of bilateral combined hamartoma of retina and retinal pigment epithelium. Method Bilateral heterologous plasmin-assisted lens-sparing vitrectomy was performed. The surgical specimen underwent histopathological and immunohistochemical analysis. Patient An 18-month-old male child with bilateral combined hamartoma of the retina and retinal pigment epithelium. Results After surgery, structural improvement (optical coherence tomography) and improved visual function were noted. Immunohistochemistry was positive for astrocytic markers and negative for others. Discussion Plasmin-assisted vitrectomy and membrane peeling in this child with bilateral combined hamartoma resulted in a marked improvement in the clinical and topographical appearance in both eyes and significantly improved visual function. The prospect of hamartoma recurrence is not a contraindication to surgical management. Immunohistochemically, the peeled epiretinal tissue showed characteristics of astrocytic origin providing insight into the possible source and structure of these membranes.