OPTIC DISK COLOBOMA and CONTRALATERAL OPTIC DISK PIT MACULOPATHY TREATED by VITRECTOMY in A PATIENT with NOONAN SYNDROME with MULTIPLE LENTIGINES

Abstract

Purpose:To report a case of Noonan syndrome with multiple lentigines with unusual ocular features.Methods:The authors describe a case of a 7-year-old girl with Noonan syndrome with multiple lentigines and anomalous optic disks.Results:A 7-year-old girl with genetically proven Noonan syndrome with multiple lentigines (PTPN11 gene mutation) and anomalous optic disks was referred for treatment of persistent macular detachment after 1 year of conservative follow-up. The right eye demonstrated an optic disk coloboma with the best-corrected visual acuity of 20/32, the left eye demonstrated an optic disk pit with serous macular detachment (best-corrected visual acuity 20/50-20/80). Optical coherence tomography demonstrated a neurosensory detachment. Twenty-five gauge pars plana vitrectomy was performed with posterior hyaloid detachment, drainage over disk pit area, and SF6 20% gas tamponade. Surgery resulted in subretinal fluid reduction and improvement of the visual acuity to 20/32.Conclusion:A case of Noonan syndrome with multiple lentigines with optic disk coloboma in the right eye and optic disk pit with related maculopathy in the left eye. To the best of the authors' knowledge, this is the first reported case describing the association of Noonan syndrome with multiple lentigines and congenital optic disk anomalies. Optic disk pit maculopathy was managed surgically because of its longstanding nature with the deteriorating visual acuity.