title: Simple hamartoma of the retinal pigment epithelium with macular edema.
abstract: OBJECTIVE
  Presumed congenital simple hamartoma of the retinal pigment epithelium (CSHRPE) is a rare intraocular finding that is described as a focal, nodular, jet black lesion. These lesions frequently occur at or near the macula and have no known association with changes in the surrounding neurosensory retina, retinal pigment epithelium, or choroid, nor have they been related with exudation or hemorrhage. Until now, there have been no cases reported of CSHRPE with associated vascular activity.
  
  
  METHODS
  A 14-year-old Hispanic adolescent girl with a presumed CSHRPE presented with adjacent macular edema. The patient was treated with an off-label intravitreal bevacizumab injection to decrease the edema. Two months later, the patient presented with improved visual acuity and decreased macular edema.
  
  
  CONCLUSIONS
  This is the first documented case of macular edema secondary to vascular activity being associated with these rare lesions. When CSHRPE is found to have secondary vascular activity and associated macula edema, treatment of intravitreal bevacizumab may lead to improved visual and anatomical outcomes.
authors.affiliation: *DO, MPH †OD ‡MD §CRA ∥BSN, MBA **BSc, CDOS ††MD, MBA Larkin Community Hospital, South Miami, Florida (AB); and Murray Ocular Oncology and Retina, Miami, Florida (ASG, VMV, ACW, AL, FJE, TGM).
authors.forename: Austin
authors.initials: A
authors.lastname: Bach
authors.forename: Aaron S
authors.initials: AS
authors.lastname: Gold
authors.forename: Victor M
authors.initials: VM
authors.lastname: Villegas
authors.forename: Andrea C
authors.initials: AC
authors.lastname: Wildner
authors.forename: Azeema
authors.initials: A
authors.lastname: Latiff
authors.forename: Fiona J
authors.initials: FJ
authors.lastname: Ehlies
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Murray
mesh_terms: D000293:Adolescent; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000068258:Bevacizumab; D005260:Female; D005451:Fluorescein Angiography; D006222:Hamartoma / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D012164:Retinal Diseases / Q000150:complications* / Q000175:diagnosis; D055213:Retinal Pigment Epithelium / Q000473:pathology*; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab