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A Journal on Ophthalmology
Minerva Oftalmologica 2012 September;54(3):149-52
Optic disk duplication, pseudoduplication or inflammatory coloboma?
Isaia E., Zuccheri G., Damiani F., Lanzafame P., Actis AG., Rolle T.
Sezione di Oftalmologia, Dipartimento di Fisiopatologia Clinica, Clinica Oculistica, Università degli Studi di Torino, Torino, Italia
Doubling of the optic disc is a rare clinical diagnosis that must be differentiated from pseudodoubling conditions such as genetic chorioretinal coloboma, retinal atrophic areas following vascular or infectious diseases, diabetic retinopathy and myopic choroidopathy. We present a case of pseudodoubling of the optic disc in a 64-year-old woman with a negative anamnesis for previous infectious or vascular diseases but with a myopic retinopathy. The funduscopy showed a disc-like lesion in the right eye and multiple atrophic colobomatous areas in the left one. The lesions were evaluated with Humphrey visual field that shows an increased dimension of physiological blind spot in the right eye and an infero-temporal scotoma with infero-nasal extension in the left eye. On fluorescein angiography both eyes have normal vessels and no double retinal circulation has been documented; neuroimaging investigations such as RM and B-scan Ultrasonography confirm the presence of only one optic nerve branch in both orbits. Finally, OCT RTVue 100 revealed absolute absence of outer retinal layers and reduction of both RPE and coriocapillary layer thickness below every colobomatous areas. In conclusion, anamnesis, clinical and instrumental investigations in this patient ruled out a diagnosis of retinal atrophic disc-like areas as consequence of myopic choroidosis development.