A 3-year-old girl presented with recurrent exotropia following primary strabismus surgery. Careful fundus examination of the left eye revealed loss of the foveal reflex and presence of a subtle grayish mass with overlying white fluff. Optical coherence tomography through the lesion revealed disorganization of inner and outer retinal layers with accompanying epiretinal gliosis. Together, these findings were suggestive of combined hamartoma of the retina and retinal pigment epithelium (CHRRPE). No syndromic association was found. CHRRPE is a rare retinal tumor that usually presents with visual loss, strabismus, or follows an asymptomatic course. Retinal tumors must be kept in mind whenever loss of foveal reflex occurs concurrently with strabismus.

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Purpose: To describe an atypical case of chronic central serous chorioretinopathy with acute exacerbation consisting of severe exudation at the site of a retinal pigment epithelium aperture.Methods: Case report.Results: A 39-year-old man presented with a recurrence of central serous chorioretinopathy in the right eye. Initial evaluation was notable for a retinal pigment epithelium aperture overlying a chronic avascular pigment epithelial detachment. He was initially treated with topical dorzolamide and indomethacin. During the follow-up, application of topical dermal steroid for a case of athlete's foot led to severe fibrinous exudation originating from the site of the retinal pigment epithelium aperture. Half-fluence verteporfin photodynamic therapy induced rapid and complete resolution of the retinal findings.Conclusion: Photodynamic therapy allowed for excellent resolution of an atypical exudative and fibrinous form of central serous chorioretinopathy associated with a retinal pigment epithelium aperture.