Optic disc coloboma: Glaucoma imitator.

A 28-year-old female, with visual acuity of 20/20 in both eyes, was referred for glaucoma evaluation. Fundus examination of the left eye was normal, and the right eye showed a large disc with 0.8:1 cup–disc ratio, central excavation which extended to the inferotemporal rim, and a corresponding inferotemporal retinal nerve fiber layer defect [Fig. 1a]. Angio optical coherence tomography (OCT) (AngioVue, OptoVue) demonstrated inferotemporal disc excavation, loss of capillaries on the surface of the optic disc, loss of radial peripapillary capillaries in the inferotemporal sector and cavitation below the disc coloboma in the corresponding B-scan [Fig. 1b]. As optic disc coloboma can be mistaken for glaucoma, careful disc evaluation and angio OCT may help in diagnosis.[1]

Figure 1

(a) Fundus photograph of the right eye shows inferotemporal disc coloboma and retinal nerve fibre layer defect (arrows). (b) Optical coherence tomography angiography demonstrates loss of inferotemporal disc capillaries and radial peripapillary capillaries and cavitation below the disc coloboma (blue arrow head)

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