Imaging congenital optic disc pits and associated maculopathy using optical coherence tomography
D. Krivoy, R. Gentile, J. M. Liebmann, Z. Stegman, R. Rosen, J. B. Walsh and R. Ritch
Department of Ophthalmology, New York, NY, USA.
OBJECTIVE: To elucidate the anatomy of congenital optic disc pits with and
without maculopathy using optical coherence tomography. SETTING: All
patient were examined, photographed, and scanned at the New York Eye and
Ear Infirmary. PATIENTS: Ten eyes of eight consecutive patients with
congenital optic disc pits were studied. Three eyes had associated serous
macular detachment (group 1), four had evidence of resolved detachment
(group 2), and three had no clinical macular pathologic lesion (group 3).
METHODS: Optical coherence tomography, a new, noninvasive, noncontact,
imaging technology capable of producing cross-sectional images of the
retina in vivo with high resolution ( < 17 microns) was used to obtain
multiple cross-sectional images of the pit, peripapillary retina, and
macula. Ophthalmologic examination and standard fundus photography were
performed on all eyes. Fluorescein angiography was performed in eyes that
had associated macular detachment. RESULTS: Communication between a schisis
cavity or subretinal space and the optic nerve pit was imaged in all eyes
in group 1. No such communication could be identified in groups 2 and 3.
Cystic degeneration and schisis were imaged in the peripapillary retina,
macula, or both in all eyes of groups 1 and 2 and in one patient in group
3. A direct communication between the subretinal space and vitreous cavity
could not be identified in any eye. CONCLUSIONS: Schisis formation plays an
integral role in the development of serous retinal detachment in the
presence of congenital optic disc pits. Our findings are consistent with
the theory that the optic disc pit acts as a conduit for fluid flow between
the schisis cavity or subretinal space and the subarachnoid space.
