Conventional colour fundus photography over multicolour imaging in identifying peripapillary intrachoroidal cavitation in myopic eyes

Clinical examination findings were documented under pupillary dilatation using the conventional colour fundus photograph (CFP) with Topcon, TRC-50Dx imaging system with 50° field of view and confocal scanning laser ophthalmoscope-based multicolour imaging on the Spectralis, Heidelberg machine with disc-centred 30° field of view. Peripapillary ICC in myopic eyes was first described by Freund et al on OCT as peripapillary detachment of RPE around the optic disc in pathological myopia.1 Later, Toranzo et al renamed this abnormality as ‘peripapillary ICC’, as this lesion was located inside the choroid and that the overlying RPE and retina were intact.2 Various theories have been described for the occurrence of peripapillary ICC in pathological myopia such as it being a congenital lesion or an acquired one occurring due to a break in the limiting membrane of Elschnig or due to excessive stretching of the weak myopic conus or due to the poor absorbing ability by the tissues of the fluid originating from the subretinal, suprachoroidal, optic canal and vitreous cavity due to ageing.3 4 In this clinical picture, we compare the conventional CFP and multicolour image of a patient with high myopia showing peripapillary ICC. Multicolour imaging is a newly introduced non-invasive imaging technique wherein light of three different wavelengths (blue: 488 nm, green: 515 nm and infrared: 820 nm) is scanned across the retina, thus enabling an alternative method of capturing fundus images.5 6 The light of three different spectrums penetrate the tissue to different depths and simultaneously capture the reflectance strengths from different retinal and choroidal structures and represent the information as an en-face composite multicolour image.