|Year : 2021 | Volume
| Issue : 3 | Page : 420-421
Unilateral isolated macular coloboma - A rare finding
Saswati Sen, Manmath K Das, Abhilash Chougule
Department of Ophthalmology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
|Date of Submission||17-Dec-2020|
|Date of Acceptance||04-Feb-2021|
|Date of Web Publication||02-Jul-2021|
Dr. Saswati Sen
Kalinga Institute of Medical Sciences, Bhubaneswar - 751 019, Odisha
Source of Support: None, Conflict of Interest: None
Keywords: Amblyopia, coloboma, laser, macula
|How to cite this article:|
Sen S, Das MK, Chougule A. Unilateral isolated macular coloboma - A rare finding. Indian J Ophthalmol Case Rep 2021;1:420-1
A 22-year-old man presented for routine check-up. His best-corrected visual acuity was 6/6 in the right eye with -0.5 sphere and 4/60 in the left eye. Anterior segment in both eyes and posterior segment in right eye was normal but isolated macular coloboma of around three disc dioptres along with shallow peripheral retinal detachment in left eye was seen [Figure 1]a and [Figure 1]b. Rest of the ocular and systemic examination was normal. There was no history of trauma or birth infections. Differential diagnosis of congenital toxoplasmosis, posterior staphyloma, macular diseases like dystrophies or maculopathies were excluded on basis of history, laterality, clinical presentation and investigations. The patient was counselled and barrage laser done for the peripheral detachment in the left eye. Glasses were prescribed and patient was asked to follow-up regularly.
|Figure 1: (a and b). (a)-Normal fundus of right eye. (b)-Macular coloboma in left eye having round punched out appearance with pigments as well as few choroidal vessels at the base|
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| Discussion|| |
Colobomas are most likely to be congenital in nature. They are rare and seen in 0.5-0.7/10.000 birth. Resulting due to the failure of fusion of the optic fissure, they are commonly found at the infero-nasal quadrant where both iris and choroidal coloboma may be seen. The other rarer atypical variant is the macular coloboma that is often bilateral and symmetrical. Mann classified macular coloboma as pigmented, nonpigmented and associated with abnormal vessels. Our case was that of a typical non-pigmented coloboma. corroborated by Ocular coherence tomography(OCT) [Fig 2]. Macular colobomas may be associated with retinitis pigmentosa or retinal dystrophies. Visual prognosis in such cases is difficult to predict as patients with colobomas and optic nerve involvement can have near-normal vision and stereopsis. Unilateral colobomas should be managed aggressively to maximize visual potential by correcting refractive error and thus preventing amblyopia., Hence, when diagnosed treatment should be prompt and counselling should be proper keeping in mind use of low vision aids. At the same time, thorough systemic examination is also warranted to rule out any associated syndromes.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
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Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2]