Abstract
BACKGROUND/AIM: Isolated retinal astrocytic hamartoma (IRAH) is a rare, benign retinal tumor that typically occurs without any clinical comorbidities. The clinical diagnosis of IRAH remains a challenge. This study reported on two patients with IRAH in the juxtapapillary region and evaluated their multimodal imaging findings. CASE REPORT: Case 1 involved a 71-year-old woman who presented with a retinal mass adjacent to the superior optic disc in her right eye. Optical coherence tomography (OCT) of the lesion cross-sections revealed thickening of the inner retinal layer, accompanied by low-reflection spots. Fluorescein angiography (FA) revealed hypofluorescence in the early and late phases. Case 2 involved a 37-year-old woman who presented with a whitish retinal tumor on the nasal optic disc in her left eye. She had a medical history of Vogt-Koyanagi-Harada disease approximately 20 years prior. OCT revealed a highly reflective mass with calcification. FA revealed fluorescein leakage from the tumor during the late phase. Laser speckle flowgraphy (LSFG) revealed cold coloration in both cases, indicating poor blood flow within the tumor. Both patients were diagnosed with IRAH, and no marked changes in the clinical characteristics of the tumors were observed during a follow-up of more than 6 months. CONCLUSION: Multimodal imaging, including LSFG, contributed to the clinical diagnosis of juxtapapillary IRAH, characterized by slow and consistent blood flow, consistent with a stable nature.