Case ReportNEWLY DIAGNOSED ASYMPTOMATIC RETINAL ASTROCYTIC HAMARTOMA IN AN OLDER ADULTGündüz, A. Kaan MD*; Shields, Carol L. MD†; Çöndü, Gökçen MD*; Gürsel, Ragip MD‡Author Information *Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey; †Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania; and ‡World Eye Hospitals, Tunus Cad, Ankara, Turkey. Reprint requests: A. Kaan Gündüz, MD, Farilya Is Merkezi 8/50, Ufuk Universitesi Cad, Cukurambar Sogutozu, Ankara, Turkey; e-mail: [email protected] A. K. Gündüz, C. L. Shields, G. Çöndü: preperation, review, and approval of manuscript, G. Çöndü and R. Gürsel: collection and analysis of data. None of the authors has any financial/conflicting interests to disclose. Ethics approval and consent to participate: This is a HIPPA-compliant, IRB-approved observational case report in accordance with The Declaration of Helsinki. Consent for publication: Obtained from the patient. Availability of data and material: A. K. Gündüz has had full access to all the data in the study and takes responsibility for the integrity of the data and accuracy of data analysis. Retinal Cases & Brief Reports: Fall 2020 - Volume 14 - Issue 4 - p 352-354 doi: 10.1097/ICB.0000000000000710 Buy Metrics AbstractIn Brief Background: To report a coincidentally discovered retinal astrocytic hamartoma in an asymptomatic older woman with no history of tuberous sclerosis or neurofibromatosis. Methods: A 63-year-old Turkish woman underwent routine ophthalmic examination. Results: Visual acuity was 20/25 in each eye. On fundus examination, the right eye showed a flat yellow-white superficial retinal lesion in the inferotemporal macula and measuring 1 mm in diameter. The lesion was unmeasurable using B-mode ultrasonography. Spectral domain optical coherence tomography revealed the mass with thickening in the retinal nerve fiber layer, with minor disorganization of the underlying retina and no retinal or vitreoretinal traction. Fluorescein angiography disclosed the mass as early isofluorescence with late mild hyperfluorescence, without leakage. Findings in the left eye were normal. Based on the clinical and imaging results, a diagnosis of noncalcified small retinal astrocytic hamartoma was rendered. The lesion remained unchanged at 1-year follow-up. Conclusion: Small coincidentally discovered retinal astrocytic hamartomas in older patients can be difficult to diagnose and possibly cause diagnostic confusion with other conditions including myelinated nerve fiber and cotton wool spot. Retinal astrocytic hamartoma is characterized by thickening of the retinal nerve fiber layer and mild compression and disorganization of the underlying retinal layers on spectral domain optical coherence tomography. Retinal astrocytic hamartoma can be diagnosed incidentally in older asymptomatic patients and is characterized by thickening of the retinal nerve fiber layer and mild compression and disorganization of the underlying retinal layers, best seen on spectral domain optical coherence tomography.