Foveal duplication artifact with spectral-domain optical coherence tomography

The authors describe a rare artifact on two different spectral-domain optical coherence tomography (OCT) systems and explain its origin in patient- rather than hardware-related errors. During evaluation on spectral-domain OCT, four patients registered twin foveal depressions on the retinal thickness map display and were initially unable to fixate on the given target. Repeat scans on the same OCT system without changing scan protocol demonstrated no artifact after the patients began to fixate well, except in one patient who had nystagmus. Fundus and autofluorescence evaluation revealed no true duplication of fovea. Performing a repeat scan with greater focus on patient compliance is necessary when such artifactual anomalies are encountered.