Foveolar simple retinal pigment epithelial hamartoma

A 28‐year‐old male patient underwent routine ophthalmic evaluation. Visual acuity was 20/20, and the anterior segment was unremarkable in both the eyes. Right eye retinal examination was normal whereas the left eye showed a healthy optic disc along with a well‐defined circular pigmented lesion at the foveola [Fig. 1a and b]. The rest of the retinal examination was within normal limits. Swept‐source optical coherence tomography (OCT) revealed a hyper‐reflective lesion just inferior to the umbo [Fig. 1c]. The hyperreflective lesion was seen just adjacent to the foveal dip in the inner retinal layers. The outer retinal and choroidal layers below the lesion were obscured because of the shadowing. However, the outer retinal and pigment epithelial layers surrounding the lesion appeared intact without any discontinuity or neurosensory detachment [Fig. 1d]. OCT angiography revealed a mildly distorted foveal avascular zone at the location of the lesion. However, the adjacent superficial retinal plexus was intact and well preserved. No abnormal or intrinsic vasculature was noted in the lesion [Fig. 1e]. The patient was counseled about the nature of the retinal lesion and advised for regular follow‐up.