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[Unusual retinal anomaly: the double papilla]
Dieter Schmidt1, Marcel Mathieu, Martin Schumacher
1Augenklinik, Universität Freiburg i. B. schmidtd@aug.ukl.uni-freiburg.de
Klinische Monatsblatter Fur Augenheilkunde
|April 16, 2003
Summary
A rare case of double optic papilla was observed in an elderly woman without a double optic nerve. This finding suggests a developmental anomaly possibly related to incomplete embryonic development and myopic changes.
Area of Science:
- Ophthalmology
- Developmental Biology
- Neuroscience
Background:
- The occurrence of a double optic papilla in relation to congenital ocular malformations remains unclear.
- It is uncertain whether this represents a true duplication of the optic nerve anlage or a malformation.
Observation:
- An 87-year-old female patient with high myopia, amblyopia, and esotropia presented with a double optic papilla in her right eye.
- Fundus examination revealed a true papilla and a smaller pseudopapilla, with widespread myopic changes in the retina and choroid.
- Magnetic Resonance Imaging (MRI) confirmed a single, normal-appearing optic nerve.
Findings:
- The study identified a double optic papilla configuration without evidence of a duplicated optic nerve.
- The smaller papilla was likely a pseudopapilla, associated with extensive myopic degeneration and possibly a colobomatous defect.
- Vascular supply to both papillae was observed, but the major vessels were not interconnected.
Implications:
- This case demonstrates that a double optic papilla can exist independently of a double optic nerve.
- The findings suggest a developmental anomaly, potentially stemming from incomplete closure of the embryonic optic cleft.
- Secondary vascular ingrowth into the pseudopapilla during embryogenesis is a plausible explanation.