Idiopathic reactive hyperplasia of the retinal pigment epithelium

Objectives: To present and discuss 2 patients with acquired peripapillary p igmented lesions. Methods: We reviewed the patients' clinical records and histopathologic fin dings. Results: The first patient was diagnosed with a pigmented papillary lesion that tvas followed up for 38 years. The second patient was a child with neu rofibromatosis type 1 who developed a pigmented peripapillary lesion follow ing excision of an optic nerve glioma. Histologic findings in both cases de monstrated hyperplasia of the retinal pigment epithelium with associated fi ndings. Conclusions: The lesions presented an idiopathic reactive hyperplasia of th e retinal pigment epithelium. The clinical and histopathologic findings res emble findings reported with the combined hamartoma. We suggest that such l esions are reactive in nature, rather than hamartomatous.