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.