Bilateral macular coloboma of sorsby: contribution of the oct

Abstract

AbstractPurpose To assess the contribution of the Optical Coherence Tomography (OCT) for the diagnosis of macular coloboma.Methods We report the case of a 33‐year‐old patient affected by a bilateral macular coloboma of Sorsby. The medical check‐up was negative. Eye fundus imaging, OCT and fluorescein angiography were performed.Results Eye fundus imaging found a deep macular defect putting the sclera to naked, pigmented, well bounded, with size about one papilla diameter in both eyes The fluorescein retinal angiography revealed a hypofluorescent macular lesion with a bigger size than the one visible at the eye fundus. The lesion was fulfilled with fluorescein in a heterogenous way during the angiographic sequence because of atrophic damage of the pigmentary epithelium and the infringement of the surrounding choroid layer area. The OCT showed in the crater shape a depression regarding the lesion with atrophy of the retinas neurosensory, the major damage of the pigmentary epithelium, the choroïd and scleral infringement regarding the lesion. We observed more marked deficits in the scleral and the choroïdal layers than in the neurosensory retina. However, changes within the retina were also visible in the form of microcysts and of disintegration of the retinal stratification.Conclusion In front of a crater macular pigmented lesion, the first diagnosis to think about is toxoplasmosis chorioretinitis, however you should not neglect a large number of other pathologies whithin the Sorsby coloboma because the scleral defect found in OCT is strongly suggestive. The OCT’s aspect of the macular lesion allows us to diagnose with more precision a macular infringement and to confirm the diagnostic of macular coloboma.