[Ocular coloboma and results of brain MRI: preliminary results]

Optic disc coloboma associated with macular retinoschisis: A case report

BACKGROUND

To report an unusual case of bilateral optic disc coloboma associated with macular retinoschisis in the left eye.

CASE SUMMARY

A 37-year-old woman presented with complaints of blurred and distorted vision in her left eye for more than 1 year. Fundus examination demonstrated choroidal atrophy around the optic disc in both eyes, with a cup-to-disc ratio of 0.9. Serous retinal detachment in the macular area of the left eye. Left eye macular blood flow imaging optical coherence tomography (Angio-OCT) showed macular retinal serous cleavage. En-face OCT showed that the canal gully-like structure formed by the defect of the optic disc nerve fiber layer between the optic disc and macula, serous detachment area was connected with the enlarged optic disc coloboma through the canal gully-like structure, and the fluid leaked from the enlarged and thinned optic disc coloboma into the retinal layer of the macular area. Patients with optic disc abnormalities and macular degeneration must be monitored appropriately. During the follow-up period, the use of optic disc stereography and 3D-OCT, en-face, and Angio-OCT imaging can clarify the correlation between macular retinoschisis and optic disc coloboma.

CONCLUSION

Macular retinoschisis may be owing to the combined force of disc edge loss, enlarged optic disc coloboma, the canal gully-like structure formed by the defect of the nerve fiber layer around the optic disc, and the traction of the posterior vitreous cortex.

A hybrid coloboma and optic disc pit associated with macular retinoschisis

Background

To report and describe an unusual case of a patient with optic disc pit in one eye and optic disc coloboma with a focal pit associated with macular retinoschisis in the other eye.

Case presentation

A 21-year-old woman presented with optic disc pit in the right eye and optic disc coloboma with a focal pit like excavation in the left eye. Macular spectral domain optical coherence tomography (SD-OCT) of the left eye revealed macular retinoschisis, without serous detachment.

Conclusions

Proper monitoring of patients with disc anomalies associated with maculopathy is mandatory. The use of OCT imaging during follow-up can help to identify involvement of the fovea or enlargement of the retinoschisis area.

[Bilateral chorioretinian colobome: about a case]

La présence d'un colobome choriorétinien soulève souvent des problèmes cliniques entraînant parfois une certaine confusion. Néanmoins, le diagnostic se doit d'être aussi précis que possible pour plusieurs raisons. L'association de certaines anomalies congénitales de la papille avec d'autres pathologies neurologiques endocriniennes ou systémiques et le problème de diagnostic différentiel avec d'autres pathologies ophtalmologiques. Nous rapportons un cas clinique d'un enfant âgé de 6 ans, le premier garçon d'une famille de 2 enfants présentant un colobome papillaire bilatéral sans d'autres anomalies malformatives associées. Dans ses antécédents: sont accouchement s'est déroulé normalement et sont statut vaccinal été à jour. L'examen ophtalmologique de son père et de sa petite sœur âgée de 4 ans été sans particularité, cependant sa mère présente un strabisme divergent à l'œil droit.

Congenital optic nerve anomalies

OBJECTIVE

To update the current knowledge about congenital optic disc anomalies.

METHODS

A comprehensive literature search was performed in the major biomedical databases.

RESULTS

Patients with these anomalies usually have poor vision in infancy. Refractive errors are common, and serous retinal detachment may develop in some of these anomalies. It is critically important to clinically differentiate between these congenital optic disc anomalies, as central nervous system malformations are common in some, whereas others may be associated with systemic anomalies.

CONCLUSIONS

Congenital optic disc anomalies are a heterogeneous group of pathologies with characteristic fundus appearance and systemic associations. We should always try to make a correct diagnosis, in order to ask for specific tests, as well as to provide an adequate follow-up.

Uveal coloboma: about 3 cases at the University Teaching Hospital, Yaounde, Cameroon

Uveal coloboma is a rare eye malformation caused by failure of the optic fissure to close during the fifth to seventh weeks of foetal life. The risk of retinal detachment increases with age in colobomatous eyes. Preventive measures such as early detection of the retinal break, prophylactic laser photocoagulation along the coloboma margin, confer a significant benefit in reducing this risk of retinal detachment. Difficulties linked to the diagnosis and management of uveal colobomas in developing countries setting are presented in this study.

Magnetic resonance imaging of optic nerve

Optic nerves are the second pair of cranial nerves and are unique as they represent an extension of the central nervous system. Apart from clinical and ophthalmoscopic evaluation, imaging, especially magnetic resonance imaging (MRI), plays an important role in the complete evaluation of optic nerve and the entire visual pathway. In this pictorial essay, the authors describe segmental anatomy of the optic nerve and review the imaging findings of various conditions affecting the optic nerves. MRI allows excellent depiction of the intricate anatomy of optic nerves due to its excellent soft tissue contrast without exposure to ionizing radiation, better delineation of the entire visual pathway, and accurate evaluation of associated intracranial pathologies.

Systemic abnormalities in children with congenital optic disc excavations

PURPOSE

Together with optic disc hypoplasia, excavated optic disc anomalies represent the most frequent congenital abnormality involving the optic nerve head. The purpose of the present study was to retrospectively review the results of a screening for extraocular abnormalities in children presenting with congenital optic disc excavations.

MATERIALS AND METHODS

The medical records of 37 patients diagnosed with a unilateral or bilateral non glaucomatous optic disc excavation were retrospectively reviewed to analyze the result of the extra ocular evaluation and to report the associated ocular abnormalities.

RESULTS

An ocular abnormality was observed in conjunction with the excavated optic disc in 31% of the eyes. The systematic investigations revealed the presence of at least one extra-ocular disorder in 48% of the cases, and the optic disc excavation could be considered as syndromic in 30% of patients. The prevalence of extraocular malformations was significantly higher in infants presenting with associated ocular malformations or abnormal vision/development.

CONCLUSIONS

The present study suggests that a systematic approach to search for any associated systemic abnormalities could be envisioned in patients presenting with congenital excavated optic discs, and particularly those presenting with abnormal vision, associated ocular defects or abnormal development.