Pseudoduplication of the optic disc initially resembling a bifurcated optic nerve in a strabismus child: a case report
Pseudoduplication of the optic disc initially resembling a bifurcated optic nerve in a strabismus child: a case report
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斜视儿童的视盘假性重复最初类似于分叉的视神经：病例报告
DOI：
10.1186/s12886-020-01369-1
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发表时间：
2020-03-14
影响因子：
2
通讯作者：
Zhao，Peiquan
中科院分区：
文献类型：
--
作者：
Huang，Liuhui;Zhang，Qi;Zhao，Peiquan
背景视神经盘假性重复是一种罕见的临床疾病，其特征是一个局限的、盘状的病变，有放射状的血管，但只有一条正常的视神经。我们报告一个罕见的情况下，最初类似于一个分叉的视神经在斜视child.Case presentationA 6岁的女孩最初被称为我们的医院由于知觉外斜视15度与固定不良的左眼。左眼视力为3/100，屈光度为+ 1.75/− 1.25 × 175。她左眼的眼底图像显示位于真实视盘下方一个椎间盘直径（DD）处的局限性和盘状病变，显示深中央杯状，类似于具有血管供应的第二个视盘。B型超音波检查显示视神经有一分叉的弱回声区，提示有两股来自视神经。光学相干断层扫描（OCT）显示了一个大的火山口样凹陷的病变，表明一个colobomatous缺陷覆盖着一个神秘的膜结构，一个扰乱的神经纤维层和缺乏规则的外视网膜层。周边检查显示相对上级缺损。磁共振成像（MRI）显示左眼地球仪形态异常，左眼视神经形状异常并向鼻侧移位。左眼眼底萤光血管摄影显示在此类盘状病灶内缺乏独立的血管。在椎间盘的颞下区，可见斑片状荧光的强荧光。双眼颞区周围血管环明显。她的右眼正常，除了血管环。我们认为这是一个视盘假性重复的病例。患者没有接受任何治疗，她的视力保持稳定，在后续count.ConclusionsOur患者提出了一个深和扩张性缺损下的视盘，真正的视神经，最初被认为是指示分叉的视神经。本病例提示在诊断双视盘视神经相关畸形前，应考虑非典型扩张性缺损。
BackgroundPseudoduplication of the optic disc is a rare clinical condition that is characterized by a circumscribed, disc-like lesion with radiating vessels but only one normal optic nerve. We report a rare case that initially resembled a bifurcated optic nerve in a strabismus child.Case presentationA 6-year-old female child was initially referred to our hospital due to perceptual exotropia of 15 degrees with poor fixation of the left eye. The visual acuity of the left eye was 3/100 with a refraction of + 1.75/− 1.25 × 175. Fundus images of her left eye revealed a circumscribed and disc-like lesion located one disc diameter (DD) below the true optic disc that showed profound central cupping resembling a second optic disc with a vascular supply. B scan ultrasonography showed an optic nerve with a bifurcated weak-echo region, suggesting that two strands originated from the optic nerve. Optic coherence tomography (OCT) demonstrated a large crater-like depression of the lesion, indicating a colobomatous defect covered by a mysterious membranous structure, a disturbed nerve fibre layer and the absence of regular outer retinal layers. A perimetric examination revealed a relatively superior defect. Magnetic resonance imaging (MRI) revealed the left eye globe showed an abnormal morphology and that the optic nerve was abnormally shaped and shifted nasally in the left eye. Fundus fluorescein angiography (FFA) of the left eye revealed the absence of independent vascular vessels in the disc-like lesion. Hyperfluorescence with patchy fluorescence was evident in the inferotemporal area of the disc. Vascular loops surrounding the temporal region were evident in both eyes. Her right eye was normal except for the vascular loop. We proposed that this represented a case of pseudoduplication of the optic disc. The patient did not undergo any treatment, and her visual acuity remained stable during the follow-up period.ConclusionsOur patient presented with a deep and ectatic coloboma below the optic disc that communicated with the true optic nerve and was originally thought to indicate a bifurcated optic nerve. This case suggests that atypical ectatic colobomas should be considered before diagnosing malformations related to the optic nerve in double optic disc cases.