Bilateral congenital simple hamartoma of the retinal pigment epithelium

Congenital simple hamartoma of the retinal pigment epithelium is a rare, benign retinal lesion, rarely seen bilaterally. This case shows a 46-year-old man initially misdiagnosed with macular dystrophy, whose vision progressively declined over several years due to concomitant cataracts. Multimodal imaging, including OCT, was key in differentiating from more serious conditions such as choroidal melanoma. With no growth or secondary complications, the lesion remains under regular monitoring. This case underscores the importance of imaging in distinguishing CSHRPE from other chorioretinal disorders.