Background: To provide a detailed report of a patient diagnosed with optic disk pseudodoubling using swept-source optical coherence tomography (SS-OCT).
Case: A 62-year-old man presented to our hospital with exudative age-related macular degeneration of the left eye. On the patient's first visit, a second optic disk was observed in the inferotemporal area of the optic disk and flat serous retinal detachment in the macula of the left eye. SS-OCT revealed that the inner layer of the retina was continuously extending toward the center of the second optic disk. However, an external limiting membrane, an ellipsoid zone, and a discontinuous retinal pigment epithelium were observed around the second optic disk. In addition, the central depth of the second optic disk corresponded to the hyper-reflection at the lamina cribrosa of the main papilla, whereas the reflection of the choroid membrane could not be confirmed. Absence of the optic nerve was confirmed based on the clear observation of high reflection, which appeared to be the boundary line of the sclera in the central depth of the second optic disk. Fluorescein angiography revealed that the retinal artery from the main optic disk was continuous with the ring-like blood vessels present in the center of the second optic disk, and capillaries radially extended in the second optic disk from the ring-like blood vessels. Low fluorescence in the second optic disk and no defect in the choroidal blood vessels were detected using indocyanine green angiography.
Conclusions: The second optic disk was similar to the main optic disk, but SS-OCT confirmed the absence of optic nerve penetration of the sclera, based on which the patient was diagnosed with optic disk pseudodoubling. SS-OCT was beneficial for diagnosing optic disk pseudodoubling.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 127: 621-627, 2023.