Retinal folds have been reported in the past in association with orbital tumors1-3,5,8 and in exophthalmos due to thyroid disease.3,7
It is our purpose to present two patients from our private and clinic service who demonstrated this clinical finding. One had exophthalmos due to fibrous dysplasia and the other metastatic hypernephroma of the orbit.
The parallel folds described are produced by deformation of the globe where the expanding retrobulbar mass indents the sclera. The appearance of such folds may precede the proptosis6 and give rise to hyperopia and astigmatism of varying degrees which may or may not be correctible with lenses.1,3,5
Ophthalmoscopic examination reveals horizontally parallel dark lines or folds in the posterior pole of the fundus usually running above and below the macula toward the disc. Birch-Hirschfield1 first described these folds in a patient with sarcoma of the orbit where the wrinkling of the
HEDGES TR, LEOPOLD IH. Parallel Retinal FoldsTheir Significance in Orbital Space-Taking Lesions. AMA Arch Ophthalmol. 1959;62(3):353-355. doi:10.1001/archopht.1959.04220030009002