Documenta Ophthalmologica

, Volume 137, Issue 1, pp 9–14 | Cite as

Congenital grouped albinotic spots of the retinal pigment epithelium in a patient with hemihypertrophy and café au lait spots

  • Eugenia C. White
  • Jesse D. Sengillo
  • Galaxy Y. Cho
  • Mathieu F. Bakhoum
  • Stephen H. Tsang
Clinical Case Report



To describe the finding of circularly grouped hypomelanotic spots in the central macula of a patient with syndromic characteristics.


Case report of a patient with albinotic spots grouped within the macula, café au lait spots, and left-sided hemihypertrophy.


A 15-year-old boy presented with hypomelanotic spots which were hyperautofluorescent on fundus autofluorescence imaging with no disruption of the retinal laminae or photoreceptor inner and outer segment (IS/OS) junction on spectral domain optical coherence tomography. His developmental history included hemihypertrophy, café au lait spots over his axilla and extremities, and surgically corrected left-sided cryptorchidism. Other ocular history included resolved convergence insufficiency and red–green color blindness.


It is essential to recognize that circularly grouped hypomelanotic spots are a benign condition. The location and arrangement of the hypomelanotic spots were atypical for congenital grouped albinotic spots of the retinal pigment epithelium (CGAS) as they were grouped within the macula in addition to a more characteristic linear “bear track” formation in the periphery. To the authors’ knowledge, this is the first report of CGAS present in a patient with hemihypertrophy, café au lait spots, and cryptorchidism and may represent a novel syndromic association.


Gass albinotic spots Hemihypertrophy Café au lait 



Jonas Children’s Vision Care, and Bernard & Shirlee Brown Glaucoma Laboratory are supported by the National Institute of Health [5P30EY019007, R01EY018213, R01EY024698, R01EY026682, R21AG050437], National Cancer Institute Core [5P30CA013696], the Research to Prevent Blindness (RPB) Physician-Scientist Award, unrestricted funds from RPB, New York, NY, USA. E.C.W is supported by the Sarnoff Cardiovascular Research Fellowship. J.D.S is supported by the RPB Medical Student Eye Research Fellowship. S.H.T is a member of the RD-CURE Consortium and is supported by the Tistou and Charlotte Kerstan Foundation, the Schneeweiss Stem Cell Fund, New York State [C029572], the Foundation Fighting Blindness New York Regional Research Center Grant [C-NY05-0705-0312], the Crowley Family Fund, and the Gebroe Family Foundation.

Compliance with ethical standards

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with a financial interest (such as honoraria; educational grants; participation in speaker’s bureaus; membership, employment, consultancies, stock ownership or other equity interest; and expert testimony or patent-licensing arrangements) or non-financial interest (such as personal or professional relationship, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Statement of human rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Statement of the welfare of animals

This article does not contain any studies with animals performed by any of the authors.

Informed consent

The data presented in this study, including images and genetic testing results, are not identifiable to individual patients. For this type of study, formal consent is not required.

Supplementary material

10633_2018_9639_MOESM1_ESM.pptx (26.7 mb)
Supplementary material 1 (PPTX 27367 kb)


  1. 1.
    Parke JT, Riccardi VM, Lewis RA, Ferrell RE (1984) A syndrome of microcephaly and retinal pigmentary abnormalities without mental retardation in a family with coincidental autosomal dominant hyperreflexia. Am J Med Genet 17(3):585–594. CrossRefPubMedGoogle Scholar
  2. 2.
    Battaglia Parodi M, Iacono P (2004) Indocyanine green angiography pattern of congenital grouped albinotic retinal pigment epithelial spots. Semin Ophthalmol 19(3–4):114–116. PubMedCrossRefGoogle Scholar
  3. 3.
    Kim DY, Hwang JC, Moore AT, Bird AC, Tsang SH (2010) Fundus autofluorescence and optical coherence tomography of congenital grouped albinotic spots. Retina 30(8):1217–1222. CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    McCulloch DL, Marmor MF, Brigell MG et al (2015) ISCEV Standard for full-field clinical electroretinography (2015 update). Doc Ophthalmol 130(1):1–12. CrossRefPubMedGoogle Scholar
  5. 5.
    McCulloch DL, Marmor MF, Brigell MG et al (2015) Erratum to: ISCEV Standard for full-field clinical electroretinography (2015 update). Doc Ophthalmol 131(1):81–83. CrossRefPubMedGoogle Scholar
  6. 6.
    Arana LA, Sato M, Arana J (2010) Familial congenital grouped albinotic retinal pigment epithelial spots. Arch Ophthalmol 128(10):1362–1364. CrossRefPubMedGoogle Scholar
  7. 7.
    de Miranda HA, Costa MC, Frazão MAM, Simão N, Franchischini S, Moshfeghi DM (2016) Expanded Spectrum of congenital ocular findings in microcephaly with presumed Zika infection. Ophthalmology 123(8):1788–1794. CrossRefPubMedGoogle Scholar
  8. 8.
    Rochels R, Knieper P, Wunderlich* M (1980) Hemihypertrophia faciei und Papillenanomalien. Klin Monbl Augenheilkd. 176(5):813–815. CrossRefPubMedGoogle Scholar
  9. 9.
    Gass JDM (1989) Focal congenital anomalies of the retinal pigment epithelium. Eye 3(1):1–18. CrossRefPubMedGoogle Scholar
  10. 10.
    Tucci A, Saletti V, Menni F et al (2017) The absence that makes the difference: choroidal abnormalities in Legius syndrome. J Hum Genet 62:1001–1004. CrossRefPubMedGoogle Scholar
  11. 11.
    Viola F, Villani E, Natacci F et al (2012) Choroidal abnormalities detected by near-infrared reflectance imaging as a new diagnostic criterion for neurofibromatosis 1. Ophthalmology 119(2):369–375. CrossRefPubMedGoogle Scholar
  12. 12.
    Hivelin M, Wolkenstein P, Lepage C, Valeyrie-Allanore L, Meningaud JP, Lantieri L (2010) Facial aesthetic unit remodeling procedure for neurofibromatosis type 1 hemifacial hypertrophy: report on 33 consecutive adult patients. Plast Reconstr Surg 125(4):1197–1207. CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Jonas Children’s Vision Care, and Bernard & Shirlee Brown Glaucoma LaboratoryNew YorkUSA
  2. 2.Department of OphthalmologyColumbia UniversityNew YorkUSA
  3. 3.Louisiana State University Health Sciences CenterShreveportUSA
  4. 4.State University of New York Downstate Medical CenterNew YorkUSA
  5. 5.Department of OphthalmologyNassau University Medical CenterEast MeadowUSA

Personalised recommendations