Indian Journal of Ophthalmology

PHOTO ESSAY
Year
: 2020  |  Volume : 68  |  Issue : 3  |  Page : 516--517

Aborted bridge coloboma with scleral fistula


Debdulal Chakraborty1, Dipankar Das2,  
1 Department of Vitreoretina Services, Disha Eye Hospitals, Kolkata, West Bengal, India
2 Department of Ocular Pathology, Uveitis and Neuro-Ophthalmology Services, Sri Sankaradeva Nethralaya, Guwahati, Assam, India

Correspondence Address:
Dr. Debdulal Chakraborty
Department of Vitreoretina Services, Disha Eye Hospitals, Ghosh Para Road, Barrackpore, Kolkata - - 700 120, West Bengal
India




How to cite this article:
Chakraborty D, Das D. Aborted bridge coloboma with scleral fistula.Indian J Ophthalmol 2020;68:516-517


How to cite this URL:
Chakraborty D, Das D. Aborted bridge coloboma with scleral fistula. Indian J Ophthalmol [serial online] 2020 [cited 2020 Jul 3 ];68:516-517
Available from: http://www.ijo.in/text.asp?2020/68/3/516/278352


Full Text



A 66-year-old with best-corrected visual acuity 20/20 in both eyes was detected with retinochoroidal coloboma (RCC) [Figure 1], 1 disc diameter (DD) inferior to disc. The coloboma could be clearly divided into two parts, the superior part showing a scleral fistula. In the central part of the coloboma, there was a bridge of retinal tissue extending from the nasal edge of the coloboma for approximately 3.5DD. The temporal part of the bridge was devoid of any retinal tissue [Figure 1] and [Figure 2]. The remaining fundus was unremarkable. Intraocular pressure (IOP) was 8 mmHg. The axial length was 22.83 mm. “En-face” optical coherence tomography (OCT) [Figure 3] and- B-scan [Figure 4] and Supplementary Video 1] revealed a discontinuity of the sclera in the region of the fistula. The OCT scan [Figure 2] passing through the area of the aborted bridge of retinal tissue showed poorly differentiated retinal tissue in the nasal half and the intercalary membrane with schisis in the center of the bridge, extending toward the temporal periphery of the coloboma. The transitional zone in the temporal periphery showed subclinical retinal detachment. Partially preserved choroid with large choroidal vessels could also be seen in the region of the aborted bridge.{Figure 1}{Figure 2}{Figure 3}{Figure 4}

[MULTIMEDIA:1]

 Discussion



Ultra-wide-field image of RCC with scleral fistula has never been reported. We could find only two reports[1],[2] of scleral fistula in RCC, both needing treatment for the closure of the fistula. The low IOP noted in this patient did not cause hypotony maculopathy noted by Gupta et al.[1] and inflammation noted by Mori et al.[2] En face OCT showed the fistulous opening that had never been described. In the region of the aborted bridge of retinal tissue, the choroidal layer could be detected on structural OCT. The temporal periphery of the RCC showed a subclinical retinal detachment, which has been described by Gopal et al.[3] B scan ultrasonography showed a well-defined area of retinochoroidal excavation inferior to the disc, with an area of absence of all three coats of the eye, suggestive of scleral fistula.

 Conclusion



The use of Optos, OCT, and B-scan together can help us understand and evaluate these patients in a better way.

Acknowledgements

We would like to thank: Mr Sudip Ghosh, Ophthalmic photographer. Disha Eye Hospitals Kolkata, West Bengal, India.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Gupta A, Narang S, Gupta V, Sharma A, Pandav SS, Singh P. Successful closure of spontaneous scleral fistula in retinochoroidal coloboma. Arch Ophthalmol:2001;119:1220-1
2Mori S, Komatsu H, Watari H. Spontaneouspos- terior bulbar perforation of congenital scleral colo- boma and its surgical treatment: A case report. Ophthalmic Surg 1985;16:433-6.
3Gopal L, Khan B, Jain S, Prakash VS. A clinical and optical coherence tomography study of the margins of choroidal colobomas. Ophthalmology 2007;114:571-80.