Ridge-shaped Peripapilla

Retin Cases Brief Rep. 2022 Aug 12. doi: 10.1097/ICB.0000000000001308. Online ahead of print.


Purpose: To report a case of peripapillary subretinal fluid associated with a ridge-shaped morphology surrounding the optic disc, which we termed ridge-shaped peripapilla.

Methods: Case report.

Results: A 6-year old girl with mild to moderate myopia was referred for an abnormal fundus appearance of the left eye. Fundus examination of the left eye showed a vertical whitish elevation just temporal to the disc with pigment clumping. Spectral domain optical coherence tomography (OCT) of the left eye showed an elevation of the fundus at the temporal edge of the disc with thinning of the choroid overlying the thickened scleral protrusion and a serous subretinal fluid. Fluorescein angiography (FA) of the left eye showed a hyperfluorescent area without leakage at the temporal edge of the disc, indicative of retinal pigment epithelium (RPE) atrophy. There was no sign of choroidal neovascularization. Based on the FA and OCT findings, the protrusion of the sclera seemed to result in overlying choroidal thinning with choroidal blood flow disturbances, and consequent RPE atrophy, leading to the subretinal fluid.

Conclusion: This case highlights an unusual presentation of ridge-shaped peripapilla, characterized by inward convexity of the peripapillary area with a ridge-shaped morphology and localized thickening of the peripapillary sclera, in eyes with myopia.