Pits, or Crater-Like Holes, in the Optic Disk

Pit-like changes of the optic nerve head in open-angle glaucoma.

“…Pitting of the optic nerve head is well described (Greear, 1942;Sugar, 1962;Duke-Elder, 1964;Walsh and Hoyt, 1969;Smith, 1977). These ectasias characteristically involve superior and inferior temporal margins of the disc tissue.…”

“…It is believed to be similar in pathophysiology to more extensive colobomas of the optic nerve and ocular tunics (Greear, 1942;Sugar, 1962;Duke-Elder, 1964;Walsh and Hoyt, 1969;Smith, 1977). Associated visual field defects have been described in cases of congenital pitting of the optic nerve head (Greear, 1942;Sugar, 1962;Duke-Elder, 1964;Walsh and Hoyt, 1969). Except in cases with transudation and sensory retinal detachment, however, such pathology is considered selflimited and stable.…”

The Prevalence of Optic Disc Pits and Their Relationship to Glaucoma

“…[3][4][5] Visual field defects associated with pits including arcuate and paracentral scotomas have been described. [6][7][8] However, the consensus was that these were not progressive. [6][7][8] Radius described incident pits of the optic disc in open-angle glaucoma (OAG), both clinically and histologically, demonstrating an association with glaucoma progression, presence in low-tension glaucoma, and limitation of the pit to within the substance of the lamina cribrosa.…”

“…[6][7][8] However, the consensus was that these were not progressive. [6][7][8] Radius described incident pits of the optic disc in open-angle glaucoma (OAG), both clinically and histologically, demonstrating an association with glaucoma progression, presence in low-tension glaucoma, and limitation of the pit to within the substance of the lamina cribrosa. 9 Subsequently, a number of authors confirmed these findings in clinic-based case-control studies.…”

Histopathology of optic nerve pit-associated maculopathy

“…Serous macular detachment and subsequent visual sequela typically develop in adulthood in approximately 25% to 75% of eyes with optic nerve pits 2,6–8. Interestingly, optic nerve pits that are located centrally have not been associated with serous maculopathy 9. Due to the overall poor visual prognosis of optic pit-associated maculopathy, a complete understanding into the source of the subretinal fluid and the mechanism of macular detachment is essential.…”