Post-inflammatory ectopia of the macula resulting in apparent hypertropia.

ECTOPIA of the macula is a rare condition, having been recorded in the literature only eight times (although a few instances of the condition have also been noted in the foetal eye). Its apparent rarity is thought to justify the publication of a further case, in which a vertical displacement of the macula resulted from an attack of choroido-retinitis. Ectopia of the macula may be produced by several mechanisms. The anomaly may be developmental and congenital, associated with other eye defects (coloboma of the choroid, coloboma of the disc, etc.). The earlier recorded cases were of this type (Pfluiger, 1885; Bernhard, 1898; Lange, 1900; Kruger, 1913; Triebenstein, 1919). Some of these cases may, however, have been post-inflammatory. A less common developmental type is that due to an alteration in the rate of growth of the posterior pole of the eye during the early postnatal period. Mann (1937) notes that there is normally a movement of the macula away from the optic disc in the newborn and that this process may be limited or exaggerated by environmental factors. A case of this type was recorded by Cohen and Weisberg (1950). The third and probably commonest aetiological factor is traction on the retina by post-inflammatory fibrous bands which may result from either a pre-natal or post-natal inflammatory lesion, and unlike the developmental group the ectopia of the macula in these cases is usually unilateral. Cases of this type have been described by Beselin (1924), Bielschowsky (1930; a bilateral case with fundus lesions like hereditary syphilis), Stein (1931; a unilateral case resulting from ignipuncture for detached retina), Friedman (1942; a unilateral case with a lesion near the macula, thought to be related to birth trauma), and Blaxter (1951; a unilateral case following choroido-retinitis). The present case also falls into this category.