|Year : 1985 | Volume
| Issue : 3 | Page : 175-176
Optic pit and central serous detachment
Gandhi Eye Hospital, Aligarh, India
Gandhi Eye Hospital Aligarh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Pahwa V. Optic pit and central serous detachment. Indian J Ophthalmol 1985;33:175-6
This condition is not uncommon and was first reported by Wiethe. It is usually unilateral although both eyes may be involved. The pit is usually single, close to the margin of the disc or more rarely situated near its centre. It never extends beyond the margin of the disc, although it may deform the papilla into oval shape. It is usually situated in the lower temporal quadrant of the disc, rarely on the nasal side and still more rarely in the upper quadrant.
Optic pit is considered as a minimal coloboma of the disc, usually in a typical position. There is herniation of the neural ectoderm associated with coloboma elsewhere indicating active proliferation of the retina tissues, in this case into the disc.
Patients with this disorder are usually seen between the ages of 20 and 40. The serous retinal separation is usually confines to posterior pole and extends in an oval or tear drop configuration from the margins of the optic pit. If the serous detachment is long standing, there frequently are mottled specks of hyper and hypopigmentation in the retinal pigment epithelium, cystoid macular change or a partial to full thickness macular hole.
| Case report|| |
A 28 years old male was admitted in the hospital with complaints of diminution of vision in right eye. Anterior segment was normal and fundus examination showed optic pit and serous detachment of macula [Figure - 1]. Visual acuity in right eye was 6/60. Optic pit was situated in the lower temporal quadrant of disc, the size of the optic pit was about 1/4 the size of the disc and the retinal vessels had normal arrangement.
Flourescein Angiography showed late staining of the optic pit without flow of dye to the area of serous separation [Figure - 2][Figure - 3]. There was atrophic pigment epithelium in the papillo-macular bundle. Photocoagulation treatment was not given. There is no other known treatment.
| Discussion|| |
The cause of the changes at macula is disputed, but they are certainly secondary to the anomaly at the disc. Gass has postulated that fluid may enter the subretinal space from either vitreous or from the spinal subarachnoid space. Most authorities subscribe to the latter theory. Similarly Sugar had suggested that it might result from the mechanical seepage of the intraocular fluid into the pit and up this bundle of fibres.
Pathological examination of optic pit has been few. It is agreed that the pit is formed by rudimentary retinal tissue with glial elements and remnants of nerve fibres and pigment epithlium. In the region of the pit the lamina cribrosa is defective and the entire anomalous arrangement is limited within the dural sheath, the sclera and choroid being normal. The nerve fibres from the retina skirt its margin on their way to the optic nerve.
Clinical symptoms may well be absent so that the anomaly is often discovered accidentally. Frequntly however defects are present in the visual field, the most common of which are the enlargement of blind spot and sector defects and particularly partial or complete paracentral or central scotoma.
Some of these serous detachments of the macula spontaneously reattach. Treatment with photoccagulation is of limited or no value(7). Sometimes abnormal vessles deep in the pit cause late staining of the pit and nerve head and occasionally these vessels may actually leak into the subsensory retinal space. Photocoagulation treatment has been used in these cases, but its true value in comparison to the natural history still require documentation.
| Summary|| |
A case report of central serous detachment and optic pit is presented.
| References|| |
Duke-Elder, S., 1964, System of Ophthalmology Vol. III. Part 2.
Patz. Fine and Orth, 1976, Diseases of Sights and Sounds in Ophthalmology. Vol. 1.
Sugar, H.S., 1962, Amer. J. Ophthalmo 52 : 307.
[Figure - 1], [Figure - 2], [Figure - 3]