Ridge‐shaped peripapila dry, fluid associated, and self‐resolved fluid associated presentations

Abstract

Purpose: We aim to describe three different clinical presentations of ridge‐shaped peripapilla.Methods: A series of case reports. Fundus images, autofluorescence (AF), optical coherence tomography (OCT) Angio‐OCT, indocyanine (ICG) and fluorescein angiography (FA) was performed.Results: The first case is a 55‐year‐old woman, that was referred to the clinic due to central visual acuity loss in her left eye. RPE atrophy, and a scleral nasal protrusion (same configuration on both eyes) with a thinned overlying choroid, with subretinal fluid around the peripapillary area and the submacular area was observed on the OCT. FA and ICG with no hotspots, nor any dilated choroidal vascular pattern was observed, nor any signs of a neovascular membrane (NVM). On FA patched hypoAF was observed around the nasal retina. Posterior staphyloma was corroborated with ocular echography. Four months after initial presentation, fluid resolved spontaneously, visual acuity improved, but fundus pigmentary defects remained unchanged. The second case is a 60 year‐old woman (OS), peripapillary subretinal fluid was observed on the oct, choroidal thinning and scleral protrusion nasal to the optic disc. The third case, a 70‐year‐old male (OD), showed a temporal whitish lesion, engorged scleral protrusion was seen on oct, with overlying RPE atrophy, very thinned choroid and retina, without subretinal fluid.Conclusions: Pathologic myopia is defined as myopic refractive error greater than −6.00 diopters. Many chorioretinal findings have been described regarding this condition, one of these is a ridge shaped peripapilla, a form of scleral protrusion around the optic disc. These patients presented on the fluorescein angiography and OCT findings, signs of protrusion of the sclera that seemed to result in overlying choroidal thinning with choroidal blood flow disturbances, and consequent RPE atrophy, leading to the subretinal fluid accumulation.