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Ophthalmic Images |

Infrared Reflectance Pattern of Macular Pits in Pathologic Myopia Online Only

Paulo Freitas-da-Costa, MD1,2; Manuel Falcão, MD, PhD1,3; Ângela Carneiro, MD, PhD1,3
[+] Author Affiliations
1Department of Ophthalmology, Hospital de São João, Porto, Portugal
2Department of Anatomy, Faculty of Medicine, University of Porto, Porto, Portugal
3Department of Sense Organs, Faculty of Medicine, University of Porto, Porto, Portugal
JAMA Ophthalmol. 2015;133(6):e1580. doi:10.1001/jamaophthalmol.2015.80.
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A patient with a macular pit, defined as a focal scleral excavation, was examined. The axial length of the pit was 30.0 mm. Ophthalmoscopic examination showed a yellowish oval lesion within a wide area of chorioretinal atrophy. A ringlike low reflectance pattern was detected on infrared examination (Figure, A). Spectral-domain optical coherence tomography revealed a focal scleral ectasia with no overlying retina (Figure, B). The sclera was approximately one-third thinner (98, 77, and 50 μm for the pit’s floor, temporal wall, and nasal wall, respectively), and the choroid was obliterated. The pit had a homogeneous low autofluorescence. Fluorescein angiography showed a branch of a posterior ciliary artery in the vicinity of the lesion. The pit was slightly hyperfluorescent in the late frames.

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Myopic macular pit. A, Infrared imaging shows an oval lesion (arrowhead) with low reflectance surrounded by a lower reflectance rim. B, Enhanced depth imaging spectral-domain optical coherence tomography (high-speed horizontal scan) reveals an abrupt cavitation of the sclera into the retroocular space (width and depth of 522 × 536 μm, respectively).

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