MULTIMODAL IMAGING OF BENIGN LOBULAR INNER NUCLEAR LAYER PROLIFERATIONS.
Sharat Hegde, Krishnaprasad Kudlu, Hashim Ali Khan
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Case in brief
A 10-year-old boy was evaluated for multiple whitish intraretinal lesions and widespread pigmented spots. Examination showed bilateral lesions at the posterior pole and midperiphery, alongside extensive grouped congenital hypertrophy of the retinal pigment epithelium. Optical coherence tomography demonstrated homogeneous hyperreflective foci in the inner nuclear layer, distorting adjacent retinal layers, with variation in lesion size within and between eyes. Optical coherence tomography angiography showed no intrinsic vasculature. Clinical and multimodal imaging findings supported benign lobular inner nuclear layer proliferations associated with congenital hypertrophy of the retinal pigment epithelium.
What made this case unusual
The lesions were bilateral and associated with extensive grouped congenital hypertrophy of the retinal pigment epithelium; imaging also showed no intrinsic vasculature and variable lesion dimensions.
Diagnostic / clinical pearl
Hyperreflective inner nuclear layer foci that distort adjacent retinal layers and lack intrinsic vasculature on optical coherence tomography angiography can support recognition of benign lobular inner nuclear layer proliferations.