The patient was a 14 year old healthy, asymptomatic white boy who was found on routine examination to have a deep orange lesion below the disc. The visual acuity without correction was 20/20 J1+ OD and 20/25 J1+ OS. The examination was remarkable only for the orange lesion with mild overlying pigmented spots and surrounding hyperpigmentation. A fundus photo, OCT, and B-scan are attached. Angiography was not possible because of his sensitivity to bright lights. What is the most likely diagnosis? Is any treatment needed?
