Rare pediatric coexistence of combined hamartoma of the retina and retinal pigment epithelium and Coats' disease: Clinical course, imaging, and management.

PURPOSE: To report a rare pediatric case of juxtapapillary combined hamartoma of the retina and retinal pigment epithelium (CHRRPE) with superimposed peripheral Coats lesions, highlighting multimodal imaging and stepwise management.

METHODS

A 10-year-old boy with CHRRPE and peripheral Coats lesions was managed with targeted laser photocoagulation, followed by intravitreal anti-VEGF injection for persistent exudation. Multimodal imaging, including OCT, OCTA, and fluorescein angiography, guided diagnosis and treatment.

RESULTS

Two-year follow-up demonstrated stable retinal lesions, preserved visual function, and absence of vitreoretinal traction or neovascular glaucoma. Multimodal imaging allowed differentiation of overlapping lesions and guided selective intervention.

CONCLUSION

This case illustrates the importance of individualized, stepwise management in complex pediatric retinal disorders and the critical role of multimodal imaging in guiding treatment.