OCT-Angiography of Idiopathic Foveal Hypoplasia and its Correlation to VA

Nova Southeastern University, Davie, Florida, USA

Background. Foveal hypoplasia is characterized by the lack of a defined foveal depression with preservation of all neurosensory retinal layers. Due to the underdevelopment of the fovea, foveal hypoplasia is generally associated with varying degrees of visual acuity reduction. Recent studies have shown that visual acuity and functioning can be linked to retinal capillary density as seen on optical coherence tomography angiography. Case Presentation. Caucasian 25-year-old female with Duane's and accommodative insufficiency. BCVA 20/20 OD, OS, OU. Normal color vision and stereo detected on Lang and Stereo Fly, but none present on Randot. Anterior segment and posterior pole are WNL on biomicroscopy. Clinical Testing. Fundoscopy is unremarkable. OCT shows absence of a foveal pit OU. There was an absence of the Foveal Avascular Zone (FAZ) in the superficial and deep retinal capillary plexi on OCT-Angiography. Plan/Treatment. Monitor. Further ERG and VEP testing. Discussion. In foveal hypoplasia the superficial retinal capillary plexus is present, while the absence of the deep capillary plexus can vary. A recent study determined that the absence or diminution in diameter of the foveal avascular zone particularly of the deep plexus correlates with visual potential associated with foveal hypoplasia. Individuals with unimpaired visual acuity were found to have preservation of the deep retinal capillary plexus foveal avascular zone. Conclusion. Lack of a FAZ in both the superficial and deep retinal capillary plexus in a patient with idiopathic hypoplasia with preserved visual acuity was demonstrated using OCT-A.