'Pseudo'-Combined Hamartoma Following Papilledema

To the Editor. —Combined hamartomas of the retina and retinal pigment epithelium are uncommon tumefactions characterized by proliferation of the retinal pigment epithelium, retina, and overlying vitreous.1-3The lesions have a predilection for the juxtapapillary area. They are slightly elevated and are often accompanied by contracture of the retina by an epiretinal membrane. The lesions have little or no growth potential. The observation of these lesions in infants and children has suggested a congenital origin. Herein, we describe fundus changes similar to combined hamartoma of the retina and retinal pigment epithelium that were documented to arise from an apparently normal retina in a patient with papilledema. Report of a Case. —An 11-year-old boy presented in April 1986 with decreased vision in his right eye of one year's duration. He had undergone multiple neurosurgical procedures for congenital hydrocephalus. Fundus photographs had been obtained in 1982; they documented bilateral swelling of