Optic disc pseudoduplication accompanied with macular hole

A 68-year-old man presented with decreased vision in his left eye since 2 months ago. His best corrected visual acuity (BCVA) was 20/400. During the fundus examination, a disc-like lesion was observed inferior to the left optic nerve. A full-thickness macular hole was also detected and determined to be the main cause of his declining vision which needed surgical management [Fig. 1a]. fluorescein angiography was performed [Fig. 1b], and B-scan ultrasonography then revealed that there was only one true optic nerve.

Figure 1.

(a) Color fundus photograph of the left eye revealed optic nerve pseudo duplication. The colobomatous lesion was half disc diameter in size and mildly excavated. (b) Fluorescein angiogram showed that the inferotemporal retinal vein dipped in the lesion before reaching the optic nerve; however, the arterial vasculature seemed to be normal

Optic disc doubling is very rare in humans but colobamatous lesions, as seen in our case, can simulate the optic nerve.[1,2]

Optic disc congenital colobomas are very rare and may be diagnosed as optic disc duplication which does not usually impair the patient's visual acuity and might be accompanied by other retinal lesions.

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