Distinguishing Glial Tissue from Optic Disc in Bergmeister's Papilla Using OCT Angiography

A 55-year-old asymptomatic woman was found to have bilateral abnormalities of the optic nerve during an ophthalmic examination. Ocular examination revealed visual acuity of 20/20 in both eyes with normal anterior segment. Fundus examination showed grayish-white glial tissue covering the optic nerve (A) as confirmed by infrared image (B) from OCT. Cross-sectional OCT image (C) exhibited hyperreflective membrane overlying the optic disc, and adhesions to adjacent optic papilla structure (white arrow). The corresponding OCT angiography B-scan with flow overlay (D) showed hyperreflective tissue without any flow signal, contrasting with the optic disc's normal blood flow signal (Magnified version of Figure A-D is available online at www.aaojournal.org).