A 12-year-old girl who presented with strabismus in both eyes for six months was found poor visual acuity --0.05 in the right eye, while 0.3 in the left eye.

Color fundus image of right eye revealed a gray-white elevated mass involving the optic disc with white proliferative membrane covering the temporal part of the disc (fig. color fundus image). On the high-resolution radial B-scan images, no normal fovea was noted. Multiple RPE elevations were observed (gif.).

Neurosensory retina around disc was disrupted with intraretinal cysts. Optic disc SS-OCTA demonstrated that the central hyperreflective area at disc on B-scan image corresponding to the proliferative tissue showed a complete absence of flow signal (fig. yellow star), while a rich, intricate network of tortuous peripapillary vessels was clearly revealed surrounding the elevated tumor.

In contrast, peripheral vessels exhibited abnormal straightening (fig. OCTA). All these OCTA findings correlated well with FFA. This patient was diagnosed as Combined Hamartoma of the Retina and Retinal Pigment Epithelium (CHRRPE) in the right eye

A 100kHz full-range SS-OCTA (YAlkaid, TowardPi Medical) was used in this case to achieve high-resolution OCT and OCTA images of optic disc. With outstanding algorithms, the flow signals can be detected with high resolution and high reliability in complex cases.

Case courtesy of: Dr. Lili Guan and Dr. Jingchao Liu from Junan Bright Eye Hospital.