case_images: PMC11018332_01
case_images: a Fundus photography illustrates a temporal protrusion of the optic disc. b Higher magnification of the optic disc. White arrowheads show a temporally protruding optic disc. c Humphrey perimetry 10-2 analyzer shows a VF defect in the corresponding area of the PMB. d Humphrey perimetry 30-2 analyzer shows the enlargement of the blind spot. e, f Swept-source optical coherence tomography (OCT) across the temporally protruding site of the optic disc. The white line shows an anterior surface of lamina cribrosa, and the yellow dotted line shows the area of the focal lamina cribrosa defect (f). f Horizontal OCT image of the macula. LC, lamina cribrosa; LCD, lamina cribrosa defect; PT, prelaminar tissue.
case_images: cop-2024-0015-0001-538440_F01.jpg
case_images: PMC11018332_01_cop-2024-0015-0001-538440_F01.jpg
case_images: F1
case_images: Fundoscopic examination revealed a tigroid fundus with thinning of the temporal rim of the optic disc rim and significant peripapillary atrophy (Fig. 1a, b). Remarkably, the optic disc's temporal side protruded toward the macula (Fig. 1b; arrowheads). The 10-2 VF test showed a mean deviation value of -1.90 dB, with defects corresponding to the papillomacular bundle (PMB) of the RNFL (Fig. 1c). The HF30-2 VF test indicated an enlarged blind spot due to peripapillary atrophy, with no VF defect (Fig. 1d). Swept-source optical coherence tomography illustrated a horizontal section across the protruding optic disc edge toward the fovea (Fig. 1e). A closer view (Fig. 1f) disclosed a fLCD at the temporal side, recognized by three OCT specialists (T.N., While the OCT image depicted normal retinal morphology around the macula, the RNFL thickness between the macula and fLCD appeared reduced (Fig. 1f).
case_images: PMC11018332_02
case_images: a Fundus photography illustrates a temporal protrusion of the optic disc. b Higher magnification of the optic disc. White arrowheads show a temporally protruding optic disc. c Humphrey perimetry 10-2 analyzer shows a serious central VF defect. d Goldmann perimetry examination shows the enlargement of the blind spot and a central VF defect. e, f Swept-source optical coherence tomography across the temporally protruding site of the optic disc. The white line shows an anterior surface of lamina cribrosa (f). The yellow dotted line shows a large hyporeflective area in the lamina cribrosa, which was diagnosed as a focal lamina cribrosa defect (f). LC, lamina cribrosa; LCD, lamina cribrosa defect; PT, prelaminar tissue; Sc, sclera.
case_images: cop-2024-0015-0001-538440_F02.jpg
case_images: PMC11018332_02_cop-2024-0015-0001-538440_F02.jpg
case_images: F2
case_images: Fundoscopic examination showed thinning of the temporal optic disc rim, significant peripapillary atrophy, and a tigroid fundus (Fig. 2a). Similar to Case 1, the temporal side of the optic disc protruded toward the macula (Fig. 2b; arrowheads). The 10-2 Humphrey VF test revealed a severe central VF abnormality with a mean deviation value of -15.56 dB, encompassing the central VF area, including the PMB region (Fig. 2c). Goldmann perimetry showed an enlarged blind spot due to extensive peripapillary atrophy, confirming the central VF defect observed in the HF10-2 VF test (Fig. 2d). Swept-source optical coherence tomography illustrated a horizontal section across the protruding optic disc edge toward the fovea (Fig. 2e). A closer view (Fig. 2f) revealed a highly reflective anterior surface of the LC on the optic disc (white dot line). T.Y., and T.I.) (Fig. 2f, yellow dot line). The LC was fully detached from the sclera, and the thinnest prelaminar tissue on the LC was 55 mum. Horizontal OCT images across the macula depicted preserved retinal structures; however, the thinning of the RNFL and roughness of the retina were evident due to myopic diffuse chorioretinal atrophy (Fig. 2e).