Optic disc pit maculopathy: a case report

Abstract

Introduction: Optic disc pit (ODP) is a rare congenital cavitary anomaly of the optic nerve. Although ODP itself is mostly asymptomatic, visual disturbances can be caused by exudative retinal detachment (ERD) that forms due to intraretinal and subretinal fluid accumulation. Pars plana vitrectomy is considered the foremost ODP treatment tactic when maculopathy is present, however, some studies report that retinal changes can resolve spontaneously when laser photocoagulation is chosen. Case report: We present a case report of a 16-year-old female who experienced sudden vision loss in the right eye (RE) and diplopia without any trauma or systemic diseases. The best-corrected visual acuity (BCVA) with -2,25D lenses was 0,4 in RE and 1,0 in the left eye (LE). On slit-lamp fundus biomicroscopy, clear ODP in RE was present, ERD covered the center and stretched to the medial side beyond the optic nerve disc. ODP with an ERD of RE was diagnosed. Expecting spontaneous resorption, a follow-up was planned in two weeks. Unfortunately, ERD enlarged significantly. Laser photocoagulation (LP) was performed and repeated three times due to positive symptom regression. BCVA reached 1,0 in RE. Two years later, symptoms occurred again and BCVA in RE decreased to 0,6. A wide central ERD with macular and peripapillary sight involvement was detected on fundus examination. Retinal LP was repeated and after that BCVA in RE worsened to 0,3. A decreased ERD was observed and the patient was left for monitoring with prescribed glucocorticosteroid drops. During the follow-up seven months later, the patient’s BCVA improved to 1,0 in RE. ERD was absent and the patient’s condition was stable. Conclusions: Tactics for ODP maculopathy management should be selected individually after consulting a vitreoretinal surgeon. Although LP effectiveness described in the literature is controversial, our case report shows a significant visual improvement[...].