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October 2004


Tyler Metropoulos
Mountains West Ophthalmology PC
Helena, Mont



The answer to this month’s mystery image:

An Autofluorescing Astrocytic Hamartoma

The patient is a 34-year-old female without specific visual complaints. There was no past medical history of a documented phakomatosis. Visual acuity was correctable to 20/20 in both eyes, and the eye examination revealed a large astrocytic hamartoma overlying the right optic nerve. The left optic nerve appeared normal. This patient had normal visual function. There was no afferent pupillary defect.

The black-and-white photograph was taken with white light from the camera flash passing through a blue exciter filter allowing only blue light (wavelength 490 nanometers) to enter the eye. A yellow-green barrier filter on the camera lens blocked the reflected blue light, permitting only yellow-green light (wavelength 530 nm) to be recorded on film. (The fundus photo was taken for comparative purposes.)

Optic nerve drusen have been described to occasionally exhibit autofluorescence, but to our knowledge, this is the first photograph of an astrocytic hamartoma displaying this phenomenon.

Written by Robert H. Reimer, MD, of Mountain West Ophthalmology PC, Helena, Mont.

 Blink is edited by Richard E. Hackel, MA, CRA, FOPS