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PHOTO ESSAY
Year : 2021  |  Volume : 1  |  Issue : 3  |  Page : 420-421

Unilateral isolated macular coloboma - A rare finding


Department of Ophthalmology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India

Date of Submission17-Dec-2020
Date of Acceptance04-Feb-2021
Date of Web Publication02-Jul-2021

Correspondence Address:
Dr. Saswati Sen
Kalinga Institute of Medical Sciences, Bhubaneswar - 751 019, Odisha
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_3709_20

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  Abstract 


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

How to cite this URL:
Sen S, Das MK, Chougule A. Unilateral isolated macular coloboma - A rare finding. Indian J Ophthalmol Case Rep [serial online] 2021 [cited 2021 Jul 26];1:420-1. Available from: https://www.ijoreports.in/text.asp?2021/1/3/420/320085



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 Top


Colobomas are most likely to be congenital in nature. They are rare and seen in 0.5-0.7/10.000 birth.[1] 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.[2] Mann classified macular coloboma as pigmented, nonpigmented and associated with abnormal vessels.[3] 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.[4],[5] 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.
Figure 2: OCT picture of coloboma showing punched out morphology

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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.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Hornby SJ, Adolph S, Gilbert CE, Dandona L, Foster A. Visual acuity in children with coloboma: Clinical features and a new phenotypic classification system. Ophthalmology 2000;107:511-20.  Back to cited text no. 1
    
2.
Moore AT, Taylor DS, Harden A. Bilateral macular dysplasia ('colobomata') and congenital retinal dystrophy. Br J Ophthalmol 1985;69:691-9.  Back to cited text no. 2
    
3.
Mann IC. On certain abnormal conditions of the macular region usually classed as colobomata. Br J Ophthalmol 1927;11:99-116.  Back to cited text no. 3
    
4.
Chang L, Blain D, Bertuzzi S, Brooks BP. Uveal coloboma: Clinical and basic science update. Curr Opin Ophthalmol 2006;17:447-70.  Back to cited text no. 4
    
5.
Tripathy K, Chawla R, Sharma YR, Venkatesh P, Sagar P, Vohra R, et al. Prophylactic laser photocoagulation of fundal coloboma: Does it really help? Acta Ophthalmol (Copenh) 2016;94:e809-10.  Back to cited text no. 5
    


    Figures

  [Figure 1], [Figure 2]



 

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