Long‐term study of patients with congenital pit of the optic nerve and persistent macular detachment

Abstract

During the period 1970-87 we evaluated the changes of the optic disc, peripapillary area, detached macula and visual acuity in 16 cases with congenital pit of the optic nerve and macular detachment. The study revealed in 9 of the 16 cases (56%) an increase of the dimension of the pit or changes in its color, findings which were directly related to the duration of the macular detachment. Chorioretinal scarring, pigment migration, or both, were also noted mainly at the temporal margin of optic disc. In 5/16 cases we found during the follow-up an extension of macular elevation. In altogether 10 out of 16 cases the retinal elevation covered the larger portion of the mid-periphery temporally. In 7/16 cases the final visual acuity remained unchanged, in 9/16 cases deteriorated. The difference, however, in the latter 9 cases between initial and final visual acuity was negligible. During the follow-up period deterioration of the visual fields was also noted.

Visual improvement after long-standing central serous macular detachment associated with an optic disc pit

“…Two of the four had resolution of the subretinal fluid 8-10 years later, without improvement in visual acuity. Theodossiadis et al reported on the natural history of eight individuals (range of follow-up 6-14 years), all of whose final acuity was poor (≤20/200) [4]. None of the eight had resolution of the subretinal fluid.…”

“…Although spontaneous resolution of the serous detachment with visual recovery can occur within a relatively short time period of onset [2], long-standing serous detachments (over 1 year) with poor initial presenting acuity are usually associated with cystic degeneration of the macula and loss of pigment from the underlying retinal pigment epithelium, with resultant poor visual outcome [1,[3][4][5]. We report an unusual case of an optic disc pit associated with a longstanding serous macular detachment that resolved gradually over a 2.5-year period and, despite very poor presenting visual acuity, demonstrated eventual visual recovery.…”

Restoration of the photoreceptor layer and improvement of visual acuity in successfully treated optic disc pit maculopathy: a long follow-up study by optical coherence tomography

“…Patients suffering from ODP maculopathy usually have a best-corrected visual acuity (BCVA) in the affected eye equal to or less than 20/70. The BCVA further deteriorates and finally settles at 20/200 or worse [13]. Generally, the prognosis of this disease is poor.…”

Congenital Anomalies of the Optic Nerve

“…Large temporal pits are associated with a higher risk of developing macular detachments but are not associated with the extension of such detachments. 52 Visual symptoms usually begin when an associated serous macular elevation is present and are more frequent in the third and fourth decade of life. For this reason, asymptomatic patients begin to report decreased visual acuity of relatively fast progression.…”

“…54 Previous studies of serous macular detachments in OP have shown cases of both, spontaneous reattachment and persistent detachment. 52,55 Early surgical intervention such as juxtapapillary photocoagulation and vitrectomy have demonstrated the best chance at visual acuity improvement. 51 Tilted discs and congenital tilted disc syndrome Tilted disc (TD) is a condition where the optic nerve appears to enter the eye in an oblique angle.…”