Retinal astrocytic hamartoma versus choroidal osteoma: an interesting case

The clinical case presents an interesting discussion about differential diagnosis between choroidal osteoma and retinal astrocytic hamartoma. A healthy 19-year-old man presented with a dark spot on temporal field of the left eye with one month of evolution. Examination of the ocular fundus of the left eye revealed a well-circumscribed and elevated orange-yellow plaque around the optic disc and hemorrhages in the macular region. The patient was submitted to fluorescein angiography, ocular ultrasound, optical coherence tomography and optical coherence tomography angiography. The yellowish mass, the optically empty spaces and the calcifications seen in the optical coherence tomography, besides the macular hemorrhage are inherent characteristics of the two tumors, making it very difficult to reach the etiological diagnosis. An Enhanced depth imaging optical coherence tomography and a cytological evaluation through fine needle biopsy would be useful tools to clarify the diagnosis.