Idiopathic Astrocytic Hamartoma of the Optic Disc

A 71-year-old woman was referred for evaluation of an optic disc lesion in her right eye. She had a grey-white colored, semitranslucent lesion extending from the superior pole of the optic disc with overlying fine telangiectatic vessels (A-B). OCT showed origination in the nerve-fiber layer (short arrow) with a few intralesional cysts (long arrow) confirming the diagnosis of astrocytic hamartoma (C-D). The patient had no personal or family history and no clinical stigmata of tuberous sclerosis. The lesion was presumed to be idiopathic in origin. Idiopathic astrocytic hamartoma is a rare lesion, and OCT can aid in diagnosis. (Magnified version of Figure A-D is available online at www.aaojournal.org).