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N. Bhagat, B.D. Spirn, T. Forofonova, M.A. Zarbin; OCT Characteristics of an Optic Nerve Pit Associated with Retinoschisis and Retinal Detachment . Invest. Ophthalmol. Vis. Sci. 2004;45(13):2069.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To report OCT characteristics of an optic nerve pit associated with retinoschisis and serous retinal detachment. Methods: Case report Results: A 59 year–old female presented for evaluation of chronic poor vision of her right eye. Best corrected visual acuity was 20/400 OD. Anterior examination was unremarkable. Posterior segment examination revealed a large pit at the inferior aspect of the optic nerve. Shallow retinoschisis was present in the inferior peripapillary area from the inferior arcades upto the posterior equator. This was flanked by a small area of neurosensory retinal detachment. Two outer retinal holes, 1 disc area in size, were noted just inferior to the optic nerve. The macula was attached, yet no foveal reflex was present. Biomicroscopic examination of the macula revealed no subretinal fluid or edema. Fluorescein angiogram and B–scan ultrasonography confirmed these findings. OCT, however, revealed a very shallow neurosensory detachment of the macula. SLO–microperimetry displayed both relative and absolute scotoma within the macula. The patient was scheduled for focal laser to the optic nerve pit margin to resolve the minimal sub–retinal fluid seen on OCT. Conclusions: Optic nerve pit can be associated with both retinoschisis and retinal detachment. OCT can identify minimal sub–retinal fluid in the macula when biomicroscopic clinical examination, and other diagnostic tests fail to do so. The knowledge of this finding can have a significant effect on the management, treatment and hence the visual prognosis of such patients.
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