SIGNS AND SYMPTOMS
Typically, optic pits occur unilaterally (85 percent). The optic disc in these patients appears larger than normal, and 60 percent of discs with optic pits also have cilioretinal arteries. These patients have a greater propensity to develop normal-tension glaucoma.
Most patients are unaware of the presence of an optic pit. Although as
many as 60 to 70 percent of patients with optic pits possess some arcuate scotoma
corresponding to the loss of retinal ganglion cells, their acuity is rarely affected.
Patients may notice visual distortions, metamorphopsia or blurred vision. Those with
temporal pits have the greatest risk for developing serous maculopathy.
Some 40 to 60 percent of patients with optic pits develop non-rhegmatogenous serous macular detachments. These fluid-filled cystic maculopathies can develop into lamellar macular holes. The origin of the fluid is unknown. There is a high incidence of posterior vitreous detachment associated with these serous maculopathies.
Previous theories concerning the origin of the subretinal fluid seen in
optic pit-related serous macular detachment include liquefied vitreous penetration and
leaking vessels within the pit. New findings strongly suggest that serous macular
detachments secondary to optic pits develop due to pre-existing schisis-like lesions which
connect the macula to the optic disc. Fluid, predominantly from the outer plexiform layer,
enters an already edematous retina through the optic pit via the retinal stroma, producing
a macular detachment.
Treatment for optic pit-related macular detachment varies. Periodic
monitoring, prophylactic laser photocoagulation, therapeutic laser photocoagulation after
maculopathy has formed, oral steroids and vitrectomy have all been tried. The current
trend is laser photocoagulation following the onset of maculopathy.
Other reports in this section
Eyelids & Eyelashes | Conjunctiva & Sclera | Cornea
Uvea | Vitreous & Retina | Optic Nerve & Brain | Oculosystemic Disease
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