Seagull wings appearance on optical coherence tomography: A case of peripapillary detachment in pathologic myopia

Purpose: To report the case of a patient who presented with a peripapillary retinal detachment caused by pathological myopia. Observations: A 73-year-old female with a clinical history of high myopia was admitted to our ophthalmic department complaining of vision loss in her right eye. Her best-corrected visual acuity was 20/25 in the right eye and 20/400 in the left eye. The refractive error was −9.00 D in both eyes. The anterior segment and pupillary reflex were normal. Dilated fundus examination revealed myopic retinopathy in both eyes and a yellow peripapillary lesion, distinct from the myopic conus and encircling almost the whole optic disc, in her right eye. The left eye displayed macular atrophy with macular pigmentation due to a previous myopic choroidal neovascularization. Optical coherence tomography showed a localized retinal detachment in the peripapillary area, adjacent to the inferior edge of the optic disc, giving a strange “seagull wings” appearance. Conclusions and Importance: In case of peripapillary neuroepithelial detachment the presence of PDPM in high myopic patients should always be excluded. Further research is due in order to better understand this clinical entity's pathogenesis and prognosis.