This healthy 41YO female was referred for an asymptomatic lesion in her left eye. Vision was 20/25 in her normal right eye and 20/25 in her left eye. Ocular examinations were normal except for a round nodular amelanotic elevated lesion abutting (and possibly involving) the left superonasal optic nerve. Swept-source OCT shows diffuse hyperreflectivity of the lesion with posterior shadowing.
Learning Points:
pSCRAP (presumed solitary circumscribed retinal astrocytic proliferation) was originally described by Shields et al as a unique lesion found in adulthood that resembles a retinal astrocytoma or retinoma (Arch Ophthalmology 2011;129:1189-1194). Although originally felt to arise from the inner retina, it is now thought to be either a deep retinal glial lesion or a form of RPE fibrous metaplasia (Shields et al, Retinal Cases & Brief Reports 2017;11:18-23).
