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PHOTO ESSAY
Year : 2023  |  Volume : 3  |  Issue : 1  |  Page : 213

Triple trouble: Multimodal imaging in a case of optic disc pit–associated maculopathy with pseudodisc and irido-fundal coloboma


Cornea, Cataract and Refractive Surgery Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India

Date of Submission12-Jun-2022
Date of Acceptance30-Aug-2022
Date of Web Publication20-Jan-2023

Correspondence Address:
Suman Lata
Cornea, Cataract and Refractive Surgery Services, Dr. R P Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1416_22

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  Abstract 


Keywords: Iridofundal Coloboma, Multimodal Imaging, Optic Disc Pit Maculopathy


How to cite this article:
Bari A, Lata S. Triple trouble: Multimodal imaging in a case of optic disc pit–associated maculopathy with pseudodisc and irido-fundal coloboma. Indian J Ophthalmol Case Rep 2023;3:213

How to cite this URL:
Bari A, Lata S. Triple trouble: Multimodal imaging in a case of optic disc pit–associated maculopathy with pseudodisc and irido-fundal coloboma. Indian J Ophthalmol Case Rep [serial online] 2023 [cited 2023 Feb 1];3:213. Available from: https://www.ijoreports.in/text.asp?2023/3/1/213/368141



A 30-year-old man presented with blurring of vision in the left eye for four weeks. Vision and intraocular pressure (IOP) OS were 20/200 and 14 mmHg, respectively. Fundus examination revealed an optic disc coloboma with optic disc pit (ODP) along with maculopathy. A second disc with inferior fundus coloboma was noticed in line of closure of choroidal fissure. The right eye was congenitally small and non-light perceiving. The left eye had an optic disc with sharply delimited glistening white bowl–shaped excavation decentered inferiorly with dull foveal reflex and absent central glial tissue, ruling out morning glory syndrome. About 2-disc diameter inferior to the disc was a small pseudodisc with vessels emanating from it, inferior to which was an isolated inferior choroidal coloboma [Figure 1]a. Multimodal imaging of the left eye was done to highlight the features of ODP maculopathy, pseudodisc, and choroidal coloboma [Figure 1]b, [Figure 1]c, [Figure 1]d. Diagnosis of OS irido-fundal coloboma with pseudodisc and optic disc pit maculopathy was made. The patient was managed conservatively with laser photocoagulation of margins of choroidal colobomas and followed up at regular intervals.
Figure 1: (a) Ultrawide (UW) image of the left eye with ODP maculopathy, pseudodisc, and choroidal coloboma; (b) UW autofluorescence reveals hyperautofluorescent macular area and inferior sclera and hypoautofluorescent optic disc coloboma and inferior patches of choroidal coloboma; (c) Swept-source OCT (SS-OCT) highlights continuity between ODP and fovea with foveoschisis; (d) Ultrawide field (UWFA) depicts a late venous phase with hypofluorescent colobomatous inferior optic disc margin, pseudodisc with single venule emerging from it, and isolated inferior choroidal coloboma with prominent underlying choroidal vessels

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  Discussion Top


This case highlights optic disc pit as an entity in the spectrum of choroidal colobomas.[1] It also emphasizes the role of fluorescein angiography (FA) in differentiating pseudodisc from the true optic disc and the importance of optical coherence tomography (OCT) in visualizing subretinal fluid level and vitreo-retinal interface to monitor such patients.

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.
Lingam G, Sen AC, Lingam V, Bhende M, Padhi TR, Xinyi S. Ocular coloboma-A comprehensive review for the clinician. Eye (Lond) 2021;35:2086-109.  Back to cited text no. 1
    


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