• adenoma sebaceum (facial angiofibromas);
• mental deficiency;
• epilepsy-ungula fibromas;
• retinal or optic nerve astrocytic hamartomas;
• subependymal nodules;
• multiple cortical tubers;
• bilateral renal angiomyolipomas;
• renal cysts;
• cardiac rhabdomyomata;
• calcified cerebral astrocytic hamartomas;
• white ash-leaf spots on skin;
• bony changes including cortical thickening of the metatarsal and metacarpal bones.

 NOTE ABOUT MRI FINDINGS: While enhancement of the subarachnoid space is commonly associated  with meningitis, the presence of a phakomatosis increases the likelihood that the enhancement is due to pial
 or arachnoid angiomata.

 RETINAL ASTROCYTIC HAMARTOMA IN TUBEROUS SCLEROSIS

• arise from inner surface of retina or optic nerve;
• circular or oval, well circumscribed, white, elevated (although early may be flat and translucent);
• multiple lesions common;
• may calcify in a nodular pattern later in life (calcific degeneration);
• may be cystic;
• in general, little to no growth, and observation is indicated;
• occasionally—especially in younger patients—may grow progressively and may cause visual loss via vitreous hemorrhage, intraretinal and/or subretinal exudation. Some of these patients may require photocoagulation of the tumor.

 NOTE: In the Humphrey visual field, the few missed spots located superiorly in the left eye may correlate  with the inferior fundus lesion in this eye.