Visual improvement after long-standing central serous macular detachment associated with an optic disc pit

Approximately 50% of cases of congenital optic disc pits are associated with serous macular detachment. Long-standing serous detachments (over 1 year) with poor initial presenting acuity are usually associated with cystic degeneration of the macula and loss of pigment from the underlying retinal pigment epithelium, with resultant poor visual outcome.

A 43-year-old male presented with an optic disc pit and associated serous elevation of the macular region with cystic changes at the fovea.

Over the following 2 years, the patient was aware of an improvement in vision, and acuity improved from 1/60 to 6/18 with resolution of subretinal fluid, as evidenced on optical coherence tomography.

We report an unusual case of an optic disc pit associated with a long-standing serous macular detachment that resolved gradually over a 2.5-year period and, despite very poor presenting visual acuity, demonstrated eventual visual recovery.