PMC10265355_01
Optical coherence tomography (OCT) of the right eye before and after pupillary dilation. (a and b) Horizontal macular cube 512x128 scans of the right eye obtained on the spectral domain OCT machine with Cirrus HD-OCT (version 5.0; Carl Zeiss Meditec Inc., Dublin, CA) with signal strength 8/10 at 12.02 p.m. without pupillary dilation showed twin fovea-like depressions at two separate scan co-ordinates, thereby giving the impression of foveal duplication or double fovea. (c) OCT scans were repeated with the same scan specifications mentioned and signal strength 7/10 at 1.05 p.m. after adequate pupillary dilation, which showed the existence of only one foveal depression at its anatomic location.
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The OCT scan with a signal strength of 8/10 passing through two different regions of interest showed two similar looking depressions one below the other appearing as a double fovea in the patient's right eye (Figure 1(a) and (b)). After adequate pupillary dilation and proper patient counseling to cooperate for the scan, the OCT scans were repeated on the same day to confirm the finding of foveal duplication (Figure 1(c)).
Enface OCT maps before and after pupillary dilation. (a and b) The comparative internal limiting membrane-retinal pigment epithelium (ILM-RPE) maps obtained with the Cirrus HD-OCT (version 5.0; Carl Zeiss Meditec Inc., Dublin, CA) machine before and after pupillary dilation, respectively. The double depression simulating the presence of two foveae on the map before dilation is no longer present after pupillary dilation.
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This was confirmed by an internal limiting membrane (ILM)-retina pigment epithelium (RPE) map that showed a more distinct delineation of the twin fovea (Figure 2(a)). This time only one foveal dip was identified and the other one disappeared as seen on the ILM-RPE map, implying a foveal duplication artifact (Figure 2(b)).