In the present study, a case of double fovea artifact on spectral-domain optical coherence tomography (SD-OCT) was reported.

A nine-year-old male presented with blurred vision of both eyes. His best corrected visual acuity (BCVA) was 20/20 in both eyes, and complete ophthalmologic evaluation including fundus examination and fundus photography revealed no abnormality in both eyes. He underwent SD-OCT imaging with the Cirrus HD-OCT. The Macular Cube 512 × 128 protocol of his right eye revealed an unusual pseudo-duplication of the fovea in the vertical meridian. The same protocol in his left eye also rendered a pseudo-duplication of two foveas in the vertical and horizontal meridians on the retinal thickness map. Re-examination with the same OCT system and protocol was performed two weeks later after the patient received counseling on fixation during the examination, and it revealed normal contour of the fovea in both eyes.

Double fovea artifact seen in SD-OCT is a rare artifact that can possibly lead to misdiagnosis and inappropriate clinical treatment. Since the artifact was resolved with better fixation of the patient, repeating the scan with better patient compliance is necessary when such an artifact is encountered.