title: Dynamic atypical optic nerve coloboma associated with transient macular detachment.
abstract: OBJECTIVE
  Macular schisis or detachment is frequently observed in eyes with optic pits or colobomas. Although spontaneous resolution of the maculopathy has been reported, concurrent changes in the optic nerve coloboma have not. We report three cases of atypical optic nerve colobomas in which dynamic optic nerve changes coincide with the development and subsequent resolution of the associated maculopathy.
  
  
  METHODS
  We reviewed the records of three patients with dynamic optic nerve changes associated with maculopathy. All patients were observed for at least 6 months. Fundus photography and fluorescein angiography were used to document the optic nerve and macular changes.
  
  
  RESULTS
  Three patients were noted to have macular detachments without apparent optic nerve excavation. With observation, the maculopathy spontaneously resolved in each case. We documented concurrent optic nerve changes whereby atypical optic nerve colobomas became apparent over several months in all cases. In one case, we noted the simultaneous development of maculopathy in association with obscuration of a prior disc anomaly. None of the eyes had a posterior vitreous detachment. We could not identify any associated systemic conditions or reproduce the findings with external stimulation. Initial Snellen acuity ranged from 20/60 to 20/200. Final Snellen acuity ranged from 20/20 to 20/40.
  
  
  CONCLUSIONS
  Fluctuating optic nerve changes may occur in the setting of atypical optic nerve coloboma and associated maculopathy. In cases of macular schisis or detachment where an optic nerve coloboma is not readily apparent, and no other causes are identified, consideration of a period of observation prior to therapeutic intervention seems appropriate.
authors.affiliation: Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Perkins
authors.forename: Dennis P
authors.initials: DP
authors.lastname: Han
authors.forename: John R
authors.initials: JR
authors.lastname: Gonder
authors.forename: George
authors.initials: G
authors.lastname: Colev
authors.forename: Paul E
authors.initials: PE
authors.lastname: Beaumont
mesh_terms: D000328:Adult; D003103:Coloboma / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D008266:Macula Lutea; D008297:Male; D009901:Optic Nerve Diseases / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D012075:Remission, Spontaneous; D012163:Retinal Detachment / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D014792:Visual Acuity