MULTIMODAL IMAGING OF BENIGN LOBULAR INNER NUCLEAR LAYER PROLIFERATIONS

To report clinical and multimodal imaging findings of a patient with bilateral benign lobular inner nuclear layer proliferations (BLIP) associated with grouped congenital hypertrophy of retinal pigment epithelium (CHRPE) lesions.

A 10-year-old male with multiple whitish intraretinal lesions and widespread pigmented spots underwent Multimodal imaging including fundus photographs, autofluorescence, cross sectional and enface optical coherence tomography (OCT), and optical coherence tomography angiography (OCTA).

Bilateral whitish intraretinal lesions were observed in the posterior pole and midperiphery. Extensive bilateral grouped CHRPE were also noted. On OCT, the whitish lesions appeared as homogeneous hyperreflective foci within the inner nuclear layer (INL), causing distortion of adjacent retinal layers. OCTA showed no intrinsic vasculature. OCT revealed interocular and intraocular variability in lesion size and dimensions. Clinical findings and multimodal imaging confirmed the diagnosis of BLIP with associated CHRPE.

BLIP is an extremely rare benign tumor of the inner retina with only 19 cases reported in the literature till date. We present case of BLIP and provide a comprehensive overview of the existing literature.