The Importance of Optical Coherence Tomography and Autofluorescence in the Documentation of Papillary Colobomatous Fossette

Aims: To describe the importance of optical coherence tomography and autofluorescence in the documentation of papillary colobomatous fossette.

Presentation of Case: F.D.O. A 14-year-old male student is referred for evaluation of the fundus of the eye due to an alteration in the optic disc noticed by another professional who did not feel safe in the follow-up. The patient was completely asymptomatic at the time of the consultation and did not claim previous visual complaints.

She denied systemic and ocular comorbidities and did not use any systemic and topical medication.

Discussion: The congenital optic disc pit is a rare and typically unilateral congenital anomaly, consisting of a retinal herniation that extends into the subarachnoid space through a lamina cribrosa defect. 8,13,15,16

Although this condition, in most cases, does not present complications and remains asymptomatic, it can sometimes worsen with a significant decrease in visual acuity. This more serious condition can be characterized by important macular alterations, such as serous retinal detachment, cystic degenerations and degenerative pigmentary alterations. 14,16,17,18 The patient in the present report did not have any visual complaints and did not present severe structural and functional retinal damage, which highlights the importance of early diagnosis.

Conclusions: The colobomatous papilla pit is characterized by the presence of isolated cavities in the optic disc head secondary to a developmental disorder of the primitive epithelial papilla.

Its incidence is 1:10,000 people without sexual or racial predilection. It presents, in most cases, asymptomatic, unilateral in 85-95% of cases and rarely with more than one pit per disc.