Juxtapapillary retinochoroidal coloboma presenting with macular retinoschisis.

A 50-year-old male presented with three-month history of blurred vision in his left eye. His best corrected visual acuity (BCVA) was 6/9, N6 in right, and 6/39, N18 in left eye. Fundus examination revealed normal disc, large retinochoroidal coloboma (RCC) involving inferior quadrant, and an additional small colobomatous defect between the two [Fig. 1a]. Optical coherence tomography scan through macula revealed macular retinoschisis resembling ‘disc pit maculopathy with slit-like tract narrowing down to the colobomatous cavity [Fig. 1b].

Figure 1

(a) Montage color fundus of the left eye showing small coloboma (arrow) and maculopathy (Inset shows OCT scan through macula); (b) OCT through colobomatous defect showing dysplastic retina (arrowhead) and slit track connecting into sclera-choroidal excavation (arrow) (Inset shows the location of the scan in the fundus).

Schitic macula is often seen with optic disc pits, where fluid seeps into the retina from the vitreous or cerebrospinal fluid.[1] RCC has an overlying dysplastic retina or intercalary membrane which may inherently have defects resulting in rhegmatogenous retinal detachment.[2] Our present case is unique in its hybrid configuration of RCC presenting with macular retinoschisis resembling optic disc pit maculopathy. Juxta-papillary location of causative RCC lesion has the advantage of being managed with barrage laser without damaging the papillomacular bundle. No treatment was done in this case as the subject choose observation over the invasive procedure.

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