Name

Tomographie par cohérence optique swept source révélant une malformation d’origine inconnue associée à une fossette colobomateuse

To report a case of an optic disc pit (ODP) associated with a malformation of unknown origin, located between the choroid and the sclera.

We report the case of a 67-year-old female with an ODP who presented on swept-source optical coherence tomography a malformation of unknown origin.

A 67-year-old female, with a history of diabetes, was referred for diabetic retinopathy screening. The best-corrected visual acuity was 10/10 P2 in both eyes. Fundus examination of the right eye revealed an ODP in the temporal quadrant associated with a deep peripapillary yellow lesion. The left eye was normal. Fluorescein angiography showed an early hypofluorescence of ODP followed by a late hyperfluorescence, as for the peripapillary lesion a progressive centripetal dye filling was observed. SS-OCT passing through the lesion showed a round hyperreflective formation between the choroid and the sclera. This formation was associated with an interruption of the ellipsoid zone and the pigmented epithelium and a thinning of the choriocapillaris. Macular SS-OCT was normal in both eyes. OCT angiography (OCT-A) showed normal superficial and deep capillary plexuses, nonetheless, an area of low flow of the choriocapillaris was noted, towards the lesion.

In this case, an unusual formation between the choroid and the sclera was revealed on SS-OCT. Cases of scleral malformation were reported in the literature, only one team discovered an abnormality similar to this case. However, this is the first case describing such abnormality associated with an ODP. OCT-A at the level of the choriocapillaris, showed a low flow area overlying the formation. On SS-OCT, this was seen as the thinning of choriocapillaris.

SS-OCT allows us to discover new entities in the choroid and sclera, like in our case. However, larger case series are required to determine the exact origin of these lesions.