Bilateral noncalcified astrocytic hamartomas in retinitis pigmentosa: Multimodal imaging evaluation over 8 years of follow-up.

Purpose: To report the evolution of optic disk noncalcified astrocytic hamartomas in a patient with retinitis pigmentosa throughout 8 years of follow-up.

Methods: Case report.

Results: A 42-year-old white man with a diagnosis of retinitis pigmentosa was referred to our medical retinal center for the first time in 2010, for the development of a new optic nerve head lesion in the right eye. Fundus examination, fundus autofluorescence, fluorescein and green indocyanine angiography, spectral-domain optical coherence tomography were performed and confirmed the presence of a papillary noncalcified astrocytic hamartoma in the right eye. Four years later, multimodal imaging evaluation revealed in the left eye the presence of a first optic disk benign tumor, and in 2018, a second in the nasal retina, while in the right eye the sole papillary lesion increased slightly in size.

Conclusions: Noncalcified astrocytic hamartomas can occur in patients with retinitis pigmentosa and can increase in size and number in time. A complete multimodal imaging evaluation is necessary to identify and classify any kind of new lesion that, as known, are associated with these group of hereditary retinal degenerations.