A 25-year old male applied to clinic due to decreased vision in his left eye. The patient does not have any systemic disease and family history was unremerkable. The BCVAs were 20/20 in the right eye and 20/200 in the left eye. Intraocular pressures and anterior segment examinations were normal for both eyes.
Fundus examination of the right eye was normal while the left eye demonstrated a temporally located gray optic disc pit with serous macular detachment.
Horizontal and vertical OCT scans of the left eye revealed coexistence of retinoschisis and serous macular detachment which called as bilaminar fluid pattern.
Fundus autofluorescence imaging of the left eye showed the hypoautofluorescence corresponding to the serous retinal detachment and inner retinal schisis and the central hyperautofluorescence.
With these imaging findings, the patient was diagnosed as optic disk pit maculopathy and surgical intervention including pars plana vitrectomy with posterior vitreous detachment induction was recommended.
Optic disc pit (ODP) is a rare, congenital excavation of the optic nerve head. Its etiology is thought to be an incomplete closure of the embryonic fissure during fetal development, similar to other congenital optic disc anomalies such as morning glory syndrome and optic nerve colobomas. ODPs are usually unilateral, although up to 15% of the cases can be seen as bilateral. Most ODPs are located at the temporal and inferotemporal aspect of the disc and appear as a grayish, oval-shaped depression on a fundus examination. Although patients with ODPs are usually asymptomatic; some patients demonstrate significant macular changes, resulting in irreversible central visual field defects and decreased visual acutiy. These macular changes, including serous macular detachment, cystic degeneration, and degenerative pigment changes, are defined as ODP-induced maculopathy.
Credit: Kemal Tekin, M.D., from Ulucanlar Eye Training and Research Hospital
Instagram accounts: @retina.academy and @dr.kemaltekin
