Peripapillary disciform degeneration of the retina: diagnosis and treatment.

Peripapillary disciform detachments are infrequent disorders of the ocular fundus. They may occur in patients of all age groups and result from a number of different causes. It is important to suspect this potentially treatable diagnosis when a patient presents with visual loss and a rounded, oval, or tongue-like mass extending from the optic nervehead in any meridian. Accurate diagnosis depends on intravenous fluorescein angiography. The subretinal neovascular net extending from the optic nervehead peripherally can be demonstrated only with angiography. Treatment of peripapillary disciform macular degenerations with photocoagulation is often successful, but is difficult due to their location. With inadequate treatment, the subretinal neovascular membrane may continue to spread and proliferate, and with excessive treatment, there may be damage to the papillomacular nerve fiber bundle, with permanent loss of central vision. It is most important to carry out close postoperative patient follow-up and retreatment when indicated once treatment has been initiated.