This 42YO male with high myopia was referred for asymptomatic optic nerve changes. Vision was 20/30 OD and 20/25 OS.
Optos color RG imaging shows bilateral peripapillary atrophy. Clinically, this scarring is markedly excavated from the surrounding retinal plane. Triton swept-source OCT confirms peripapillary staphyloma. Localized retinal detachments are noted bilaterally, particularly within the nasal aspect of atrophy around the left nerve. Within these detachments, there is variable loss of RPE, absence of chorioid, and variable retinal disorganization.
Learning Points:
An optic nerve conus, most commonly found in high myopes, is a staphylomatous-like depression of the optic nerve and surrounding tissue.
