Omega Sign: A Distinct Optical Coherence Tomography Finding in Macular Combined Hamartoma of Retina and Retinal Pigment Epithelium

BACKGROUND AND OBJECTIVE: To report a distinct optical coherence tomography (OCT) appearance of macular combined hamartoma of retina and retinal pigment epithelium (CHRRPE). PATIENTS AND METHODS: This is a retrospective case series of four eyes of four patients with macular CHRRPE who were assessed with the help of color fundus photographs, swept-source OCT (SSOCT), and fundus fluorescein angiography wherever required. RESULTS: All four patients presented with decreased visual acuity. SS-OCT in all patients showed adherent epiretinal membrane (ERM) and localized thickening of underlying retina. An omega-shaped disorganization of inner retinal layers was seen bounded posteriorly by the outer plexiform layer. This was termed, "Omega sign." CONCLUSION: Omega sign is a characteristic feature of macular CHRRPE and may help to distinguish macular CHRRPEs from ERMs.