Abstract
Purpose :
To discuss the differential diagnosis in patients with peripapillary intraretinal fluid without signs of pachychoroid or neovascular disease on multimodal imaging.
Methods :
The charts and multimodal imaging of consecutive patients with peripapillary intraretinal fluid were assessed retrospectively. All patients that had any signs of pachychoroid disease (thickened choroid on optical coherence tomography (OCT), choroidal hyperpermeability on indocyanine green angiography (ICGA), or choroidal pachyvessels on any imaging modality) were excluded. All patients that showed any signs of neovascularization (on OCT or fluorescence angiography (FA)) were excluded. All patients without pachychoroid or neovascular disease were reviewed by two senior retina specialists, who classified these patients based on clinical characteristics on multimodal imaging including OCT, fundus autofluorescence, FA, and ICGA.
Results :
A total of 60 patients with peripapillary fluid were assessed, of which 8 cases were included in this study. The average age of these patients was 64 years (range 42-79), and 3 out of 8 cases were female. Seven out of 8 cases showed unilateral peripapillary intraretinal fluid. A broad spectrum of anomalies were visible, and although the cause of the fluid was not always fully certain, the most probable diagnoses found were optic disk pit (2 cases), stellate non-hereditary idiopathic foveomacular retinoschisis (1 case), vitreomacular traction (1 case), myopia-associated maculopathy (1 case), morning glory (1 case), and of unknown cause (2 cases).
Conclusions :
This case series shows that the presence of peripapillary intraretinal fluid without signs of pachychoroid or neovascular disease is associated with a broad spectrum of differential diagnoses. It is important to establish the correct diagnosis, so that the appropriate treatment may be chosen.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.