Optic pit
 | This article includes a list of general references, but it lacks sufficient corresponding inline citations. (May 2017) |
| Optic pit | |
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| Optic disc(# 18) |
Optic pit, optic nerve pit, or optic disc pit (ODP) is rare a congenital excavation (or regional depression) of the
Signs and symptoms
Many times, an optic pit is asymptomatic and is just an incidental finding on examination of the eye by a physician. However, some patients may present with the symptoms of a posterior vitreous detachment or serous retinal detachment. This is because optic pits are associated with these disorders and are even speculated to be the actual cause of these disorders when they arise in patients with optic pits (see "Associated Retinal Changes" below for a more in-depth discussion on this theory). The most common visual field defects include an enlarged blind spot and a scotoma. Visual acuity is typically not affected by the pit but may get worse if serous detachment of the macula occurs. Metamorphopsia (distorted vision) may then result.
Optic pits were first described in 1882 as dark gray depressions in the optic disc.
Risk factors
No particular risk factors have been conclusively identified; however, there have been a few reports that demonstrate an
Associated retinal changes
Optic pits have been associated with serous
Centrally located optic pits are less likely to cause changes in the retina. However, if located more peripherally in the optic disc, then it is more likely to cause a serous retinal detachment. Furthermore, if the optic pit is located temporally (which the majority are), then it is more likely to cause detachment of the macula because of the macula's proximity to the temporal side of the optic disc. If serous macular detachment occurs, a patient's visual acuity may become as poor as 20/200 or worse.
Treatment for optic pit-associated macular detachment involves
Diagnosis
Optic pits should be diagnosed by an
Treatment
Optic pits themselves do not need to be treated. However, patients should follow up with their eye care professional annually or even sooner if the patient notices any visual loss whatsoever. Treatment of PVD or serous retinal detachment will be necessary if either develops in a patient with an optic pit. Optic disc maculopathy can be treated with vitrectomy (removal of the vitreous in the eye).[3]
Occurrence
Optic pits occur equally between men and women. They are seen in roughly 1 in 10,000 eyes, and approximately 85% of optic pits are found to be unilateral (i.e. in only one eye of any affected individual). About 70% are found on the temporal side (or
References
- Sadun, AA (2005). "Chapter 111: Optic Disc Pits and Associated Serous Macular Detachment". In Ryan, Stephen J. (ed.). Medical Retina. Vol. 2 (4th ed.). St. Louis: Mosby. OCLC 936652565.
- Ferry, Andrew P. (September 1963). "Macular detachment associated with congenital pit of the optic nerve head: pathologic findings in two cases simulating malignant melanoma of the choroid". Archives of Ophthalmology. 70 (3): 346–57. PMID 14048795.
- Brown, Gary C.; Tasman, William S. (1983). Congenital anomalies of the optic disc. New York: Grune & Stratton. p. 31. OCLC 8931541.
- Brown, Gary C.; Shields, Jerry A.; Goldberg, Richard E. (January 1980). "Congenital pits of the optic nerve head II: Clinical studies in humans". Ophthalmology. 87 (1): 51–65. PMID 7375086– via Elsevier.
- Annesley, W; Brown, G; Bolling, J; Goldberg, R; Fischer, D (1987). "Treatment of retinal detachment with congenital optic pit by krypton laser photocoagulation". Graefe's Archive for Clinical and Experimental Ophthalmology. 225 (5): 311–4. S2CID 8083419.
- Creel, Donnell J. (November 2012). "The Electroretinogram and the Electro-oculogram: Clinical Applications". In Kolb, Helga; Fernandez, Eduardo; Nelson, Ralph; Jones, Bryan (eds.). Webvision: The Organization of the Retina and Visual System.
- Theodossiadis, George P.; Theodossiadis, Panagiotis G. (April 2005). "The macular buckling procedure in the treatment of retinal detachment in highly myopic eyes with macular hole and posterior staphyloma: mean follow-up of 15 years". Retina. 25 (4): 285–9. S2CID 35810589.
- Theodossiadis, George P.; Theodossiadis, Panagiotis G. (August 2001). "Optical coherence tomography in optic disk pit maculopathy treated by the macular buckling procedure". American Journal of Ophthalmology. 132 (2): 184–90. PMID 11476677– via Elsevier.
- Hirakata, A; Okada, AA; Hida, T. (August 2005). "Long-term results of vitrectomy without laser treatment for macular detachment associated with an optic disc pit". Ophthalmology. 112 (8): 1430–5. PMID 16024082– via Elsevier.