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Timothy Sullivan, Sung Chul Park, Shehzad Qayum, Rudrani Banik, Jeffrey M. Liebmann, Robert Ritch; Enhanced Depth Imaging Optical Coherence Tomography of Central Optic Disc Pits. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4909.
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© ARVO (1962-2015); The Authors (2016-present)
To assess lamina cribrosa (LC) structure in eyes with a clinically observed central optic disc pit (ODP) using enhanced depth imaging optical coherence tomography (EDI OCT).
Subjects with a centrally located ODP (Fig. A and F) and normal subjects were prospectively enrolled. For each eye, full ophthalmological examinations were performed including optic disc stereophotography, standard automated perimetry, and circumpapillary OCT retinal nerve fiber layer (RNFL) thickness measurement. Serial horizontal and vertical EDI OCT scans of the optic nerve head covering the central ODP area (interval between scans: approximately 30 μm) were obtained for each eye and reviewed to assess the structure of the central ODP, focusing on the LC. Spatial relationships between the central ODP and the central retinal vascular trunk (CRVT) were also investigated.
Fifteen eyes of 10 subjects with a central ODP (mean age: 63±20 yr) and 60 eyes of 30 normal subjects (mean age: 43±13 years) were included. In all 15 affected eyes, the central ODP corresponded to a full-thickness defect of the LC in EDI OCT scans, and these LC defects varied in size and shape. No such finding was detected in the normal group. In 9 affected eyes, the LC defects were completely separated by LC tissue from the LC opening for the CRVT (type 1; Fig. A-E). In the remaining 6 eyes, the LC defects were continuous with the LC opening for the CRVT, forming a large, horizontally oval opening (type 2; Fig. F-J). Ten out of 15 affected eyes (66%; five with type 1 central ODP and five with type 2 central ODP) had glaucoma. The remaining 5 affected eyes were normal, with no visual field or RNFL defects.
Central ODPs corresponded to full-thickness defects of the LC and can be classified into 2 types depending on their spatial relationship to the LC opening for the CRVT. The presence of normal eyes with a central ODP suggests its congenital etiology.
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