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C.D. Mora-Vargas, J.G. Gaviria-Carvajal, H. Camacho-Acevedo; Optical Coherence Tomography (OCT) Imaging in Optic Disc Pit Associated Maculopathy . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3637.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To describe the characteristics of OCT images in patients with typical and atypical optic disc pits with associated maculopathy, and the changes observed after LASER photocoagulation treatment. Methods: OCT images were obtained and analyzed by the authors in four patients with typical optic pits and one patient with an atypical presentation. Two patients were treated with low intensity LASER photocoagulation at the temporal peripapillary retina; OCT images were also obtained after treatment and comparison was performed with the previous ones. Results: OCT demonstrated the presence of a schisis-like cavity in the inner retinal layers in all cases of typical optic disc pits. Three of them also presented an evident central neurosensory detachment. Communication of the schisis cavity with the optic nerve was demonstrated in two cases, but direct communication with the optic pit was not observed. A lamellar macular hole (in the outer schisis layer) was observed in two cases. LASER photocoagulation was applied to the patient presenting with the schisis-like cavity without associated neurosensory detachment. OCT demonstrated a reduction of the cavity. The atypical case was a 15 year-old female complaining of metamorphopsia in the left eye. BCVA was 20/20. She presented a white-colored, 360° elevation of the optic nerve head and peripapillary retina involving the papillomacular bundle. Evaluation included visual field testing and fluorescein angiography. OCT demonstrated the presence of a deep defect in the central optic nerve with an associated schisis-like cavity in the peripapillary retina without direct communication between them. LASER photocoagulation was applied, syptoms improved and OCT revealed reduction in the retinal thickness and schisis cavity (one year follow up). Conclusions: OCT imaging is an effective method for demonstrating the classical characteristics of optic disc pits and associated maculopathy, as well as other features like lamellar macular holes. It may also aid in the diagnosis of non-typical cases. We were not able to demonstrate a direct channel connecting the optic pit and the retinal detachment, which has been proposed as a possible mechanism for the passage and accumulation of vitreous fluid in the retinal and subretinal spaces. We observed that low intensity LASER photocoagulation at the temporal peripapillary retina (presumed location of this channel), did limit the progression of the detachment and may stimulate reduction of the accumulated fluid (as documented by OCT).
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