title: Optical coherence tomographic findings at the fixation point in a case of bilateral congenital macular coloboma.
abstract: BACKGROUND
  Congenital macular coloboma is a rare ocular disease that consists of atrophic lesions in the macula with well-circumscribed borders. We report the findings of spectral domain optical coherence tomography (SD-OCT) at the fixation point in a case of bilateral macular coloboma.
  
  
  METHODS
  The subject is a 4-year-old boy. He visited our hospital at age 1 year and 4 months for the evaluation of strabismus. The fundus examination of both eyes showed round-shaped sharply-demarcated atrophic lesions involving the macula with large choroidal vessels and bared sclera at the base. Immunologic tests including toxoplasmosis, rubella, varicella, herpes virus, and human T-cell leukemia virus were all negative. At age 4 years and 1 month, cycloplegic refraction showed insignificant refractive errors and his best corrected visual acuity was 0.6 bilaterally. The SD-OCT showed a crater-like depression accompanying atrophic neurosensory retina, and the absence of retinal pigment epithelium and choroid. Examination of the fixation behavior by visuscope showed steady fixation with an area 0.5° nasal to the nasal edge of the atrophic lesion bilaterally. The SD-OCT findings at fixation area showed remaining normal retinal structures involving inner segment-outer segment (IS/OS) junction line.
  
  
  CONCLUSIONS
  The findings of SD-OCT have been shown to be useful in the diagnosis of macular coloboma. In the fixation point, the structure of retina and choroid were well preserved.
authors.affiliation: Department of Ophthalmology, Kinki University Faculty of Medicine, Osaka-Sayama, Osaka, Japan ; Nara Hospital, Kinki University Faculty of Medicine, Ikoma, Nara, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Abe
authors.affiliation: Nara Hospital, Kinki University Faculty of Medicine, Ikoma, Nara, Japan.
authors.forename: Jumi
authors.initials: J
authors.lastname: Shirane
authors.affiliation: Department of Ophthalmology, Kinki University Faculty of Medicine, Osaka-Sayama, Osaka, Japan.
authors.forename: Masuo
authors.initials: M
authors.lastname: Sakamoto
authors.affiliation: Department of Ophthalmology, Kinki University Faculty of Medicine, Osaka-Sayama, Osaka, Japan.
authors.forename: Fumi
authors.initials: F
authors.lastname: Tanabe
authors.affiliation: Department of Ophthalmology, Kinki University Faculty of Medicine, Osaka-Sayama, Osaka, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Kuniyoshi
authors.affiliation: Department of Ophthalmology, Kinki University Faculty of Medicine, Osaka-Sayama, Osaka, Japan.
authors.forename: Chota
authors.initials: C
authors.lastname: Matsumoto
authors.affiliation: Department of Ophthalmology, Kinki University Faculty of Medicine, Osaka-Sayama, Osaka, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Shimomura
keywords: macular structure; pediatric macular disease; strabismus