AN ATYPICAL CASE OF OPTIC DISK PSEUDO-DUPLICATION WITH PROLIFERATIVE DIABETIC RETINOPATHY

Area of Science:

• Ophthalmology
• Diabetic Retinopathy Research
• Retinal Imaging

Background:

• Diabetic retinopathy (DR) is a leading cause of vision loss in diabetic patients.
• Optic disc abnormalities are rare in DR, with pseudo-duplication being exceptionally uncommon.
• Understanding atypical presentations of DR is crucial for timely diagnosis and management.

Observation:

• A 63-year-old male with diabetes presented with an apparent duplicated optic disc in the superonasal periphery of his left eye.
• This anomaly was associated with a large frond of neovascularization.
• Optical coherence tomography revealed a noncolobomatous scar with choroidovitreal neovascularization.

Findings:

• Magnetic resonance imaging confirmed a single optic nerve, ruling out true duplication.
• The choroidovitreal neovascularization originated from the choroid, extending through the retina into the vitreous.
• The neovascularization mimicked new vessel formation on a duplicated disc.

Implications:

• This case highlights a rare peripheral presentation of proliferative diabetic retinopathy with optic disc pseudo-duplication.
• It underscores the importance of advanced imaging techniques in differentiating true anomalies from DR-related neovascularization.
• Successful regression with panretinal photocoagulation and anti-VEGF therapy suggests standard treatments are effective for this unusual presentation.