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Journal Français d'Ophtalmologie
Volume 39, n° 8
pages e195-e197 (octobre 2016)
Doi : 10.1016/j.jfo.2015.06.017
Lettres à l'éditeur

Isolated foveolar hypoplasia
Hypoplasie fovéolaire isolée
 

P.-Y. Quiniou a, , S. Jacquemin b, C. Favel-Vecten a, N. Salaün a
a Ophthalmology unit, Military Instruction Hospital Legouest, 27, avenue de Plantières, 57070 Metz, France 
b Military health center, 1st Artillery Regiment, Belfort, Quartier-Ailleret, 90016 Belfort cedex, France 

Corresponding author.

We report the case of a 20 year-old man, volunteer for the army. Faced with decreased visual acuity, he is addressed for expertise. There is no personal or family history.

The best-corrected visual acuity is 0.7 for the right eye and 0.8 for the left eye. The slit lamp examination objectives a symmetrical and normal anterior segment. The fundus examination (Figure 1) shows the decrease in foveal pigmentation. An autofluorescent snapshot (Figure 2) objectives decrease in physiological foveal hypoautofluorescence range. Finally, macular OCT is performed (Figure 3), showing the absence of foveal pit. Common causes of foveal hypoplasia (albinism, achromatopsia, PAX 6 mutation) being ruled out, the diagnosis of an isolated foveal hypoplasia is retained.



Figure 1


Figure 1. 

Fundus shots highlighting the marked decrease in foveal pigmentation.

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Figure 2


Figure 2. 

Autofluorescent shot of right fundus highlighting the decrease in foveal physiological hypoautofluorescence.

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Figure 3


Figure 3. 

OCT snapshot of the right macula through the anatomical foveola highlighting the absence of extrusion of the plexiform layer, the absence of foveal pit, the expansion of the outer retina. There is no lifting of subfoveal junction line IS/OS photoreceptor.

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Thomas et al. [1] proposed a classification into four stages, based on the foveal framework in optical coherence tomography (OCT). The absence of extrusion of the plexiform layer is constant in the various types of foveal hypoplasia. Then the classification takes into account the existence or not of a foveal pit. Then, the increasing thickness of the parafoveolar outer retina was evaluated (this characteristic is present in the stages 1 and 2, but not in the stages 3 and 4). Finally, the subfoveal uplift of the IS/OS junction line is the last criterion of this classification.

Therefore, our case appears as a stage 3 foveal hypoplasia according to the classification proposed by Thomas et al.

Disclosure of interest

The authors declare that they have no competing interest.

Reference

Thomas M.G., Kumar A., Mohammad S., Proudlock F.A., Engle E.C., Andrews C., and al. Structural grading of foveal hypoplasia using spectral-domain optical coherence tomography Ophthalmology 2011 ;  118 : 1653-1660 [cross-ref]



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