Unusual Coexistence of Bilateral Keratoconus and Optic Disc Pit: A Case Report

Abstract

Purpose

To report the unknown coexistence of bilateral optic disc pit and keratoconus.

Methods

A 23-year-old man with bilateral keratoconus underwent complete ophthalmology screening, with an unexpected detection of undiagnosed optic disc pit in both eyes. Computerized corneal topography (CT), Orbscan, corneal pachometry, endothelial microscopy, and optical coherence tomography (OCT) examination were performed.

Results

The corneal CT showed a keratoconus pattern in both eyes, evolved in the right eye with a minimum corneal pachometry of 336 μm in the right eye and 405 μm in the left eye. Mean endothelial cell density was 1937 cells/mm² in the right eye and 1912 cells/mm² in the left eye. The OCT scans showed the presence of the disc pit in both eyes with a normal macular thickness and profile in the right eye, and in the left eye an augmented retinal thickness in the nasal macular zone due to retinal oedema and schisis, with an initial detachment of the neuroepithelium in the parapapillary area starting from the optic pit.

Conclusions

This is the first clinical report of bilateral optic disc pit and keratoconus. Further investigations will be necessary to assess if there is a possible pathogenetic correlation between these two ocular pathologies or if this is an unusual coexistence of separate entities.

Keywords

Computerized corneal topography Keratoconus Optical coherence tomography Optic disc pit

Get full access to this article

View all access options for this article.

References

Giuffrè

Optic pit syndrome. Doc Ophthalmol 1986; 64: 187–99.

Brown

G.C.

, Augsburger

J.J.

Congenital pits of the optic nerve head and retinochoroidal colobomas. Can J Ophthalmol 1980; 15: 144–6.

Apple

D.J.

New aspects of colobomas and optic nerve anomalies. Int Ophthalmol Clin 1984; 24: 109–21.

Duke-Elder . System of ophthalmology, vol. III. London: 1964; 2: 678–92.

Mann

Developmental abnormalities of the eye. Philadelphia: J.B. Lippincott; 1957: 74–93.

Montenegro

, Bonnet

Fossettes colobomateuses de la papille: revue clinique et thérapeutique de 21 cas. J Fr Ophthalmol 1989; 12: 411–9.

Ferry

A.P.

Macular detachment associated with congenital pit of the optic nerve head. Arch Ophthalmol 1963; 70: 346–57.

Vedantham

Double optic discs, optic disc coloboma, and pit: spectrum of hybrid disc anomalies in a single eye. Calhoun FP. Arch Ophthalmol 2005; 123: 1450–2.

Theodossiadis

P.G.

, Grigoropoulos

V.G.

, Emfietzoglou

, Nikolaidis

, Theodossiadis

G.P.

Optical coherence tomography study of vitreoretinal interface in full thickness macular hole associated with optic disk pit maculopathy. Eur J Ophthalmol 2007; 17: 272–6.

10.

Apple

D.J.

, Rabb

M.F.

, Walsh

P.M.

Congenital anomalies of the optic disc. Surv Ophthalmol 1982; 27: 3–41.

11.

Farpour

, Babel

Les fossettes papillaires; diagnostic différentiel, anomalies vasculaires et cas limites. Ann Oculist (Paris) 1968; 201: 1–17.

12.

Ihalainen

Clinical and epidemiological features of keratoconus genetic and external factors in the pathogenesis of the disease. Acta Ophthalmol 1986; 178(suppl): S1–64.

13.

Johnston

M.C.

, Sulik

K.K.

Some abnormal patterns of development in the craniofacial region. Birth Defects 1979; 15: 23–42.