Combined bevacizumab and triamcinolone acetonide injections for macular edema in a patient with astrocytic hamartomas and tuberous sclerosis.

Retinal astrocytic hamartoma or retinal astrocytoma is the best-known ocular manifestation of tuberous sclerosis complex, a neurocutaneous syndrome characterized by the development of multiple disseminated hamartomas. It can have several clinical presentations, ranging from unilateral transparent, noncalcified lesions to bilateral multinodular, mulberry-like calcified tumors. Symptoms appear if the tumor involves the macula and can cause visual loss on the basis of progressive retinal degeneration. The authors report a case of a patient with tuberous sclerosis, bilateral astrocytic hamartomas, and macular edema with intraretinal hemorrhage in the left eye that has responded well to treatment with bevacizumab and intravitreal triamcinolone acetonide.