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William D. Terrell, Frederick Davidorf, John Christoforidis; Histopathology of Optic Nerve Pit associated Maculopathy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5201.
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To describe the histopathologic findings of an eye bank specimen containing an optic nerve pit with associated serous elevation of the macula and provide further insight into the mechanism of the associated maculopathy.
An eye bank specimen known to have an optic nerve pit with serous elevation of the macula was grossly examined and photographed. The globe was processed for both light (LM) and scanning electron microscopy (SEM). Two specimens were obtained by sectioning through the inferior border of the optic nerve pit. The superior section was prepared for SEM while the inferior section was prepared for LM. A Hitachi S-570 scanning electron microscope (Hitachi, Tokyo, Japan) was used to view samples for SEM while samples prepared for light microscopy were examined with a Zeiss Photomicroscope III (Carl Zeiss Microimaging, Thornwood, NY).
Few histopathological studies exist of optic nerve pit associated maculopathy with no prior studies presenting SEM analysis. The scanning electron photomicrographs revealed holes in the diaphanous membrane overlying the nerve at the edge of the optic pit (Figure 1A-B). Serial histopathology sections revealed a connection between the holes overlying the optic pit and the sub-retinal space via a schisis-like cavity in the retina. To our knowledge, this is the first histologic specimen to demonstrate the presence of a lamellar hole connecting these two cavities. In this specimen, serial sections of the optic nerve did not reveal access into the sub-retinal space from the sub-arachnoid space surrounding the optic nerve. Our finding supports syneretic vitreous to be the source of the subretinal fluid through the pathway described above.
A combined SEM/LM analysis of an eye bank specimen with optic disc pit associated maculopathy has provided further evidence into the mechanism of serous macular detachment. In our specimen, syneretic vitreous was the source of the subretinal fluid via defects in the diaphanous membrane overlying the optic disc pit.
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