“DOUGHNUT APPEARANCE” OF MACULAR MICROCYSTS DUE TO OPTIC ATROPHY ON OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY

PURPOSE: The purpose of this study was to describe the occurrence of optical coherence tomography (OCT) angiography features of microcysts in the macula due to optic atrophy. METHODS: A 63-year-old man, with a history of pituitary adenoma, was found to have disc pallor in his left eye and hyporeflective cysts in the inner nuclear layer at the macula on swept source OCT. The right eye was phthisical. Fundus fluorescein angiography and OCT angiography were performed to ascertain the cause. RESULTS: Fundus fluorescein angiography did not show any leakage, pointing to the diagnosis of microcystic macular edema (MME) due to optic neuropathy. OCT angiography and en face OCT demonstrated a striking pattern of the cysts in a circular distribution sparing the fovea at the level of the deep capillary plexus and inner nuclear layer, respectively, giving it a "doughnut appearance." CONCLUSION: Optic neuropathy-related MME demonstrates a typical pattern on OCT angiography that may help to distinguish this condition.