Optical coherence tomography findings in optic nerve pit maculopathy after vitrectomy

The purpose of this study was to present a case of optic nerve pit maculopathy and reappraise the previous concepts regarding the pathways of the fluid and the development.

A 24-year-old man had an optic nerve pit maculopathy. The visual acuity was 20/50 in the affected eye. Optical coherence tomography showed a multilayered separation of the neurosensory retina, serous retinal detachment, and the optic nerve pit with no membrane on the optic nerve. After 2 months of observations, surgery was performed.

Surgery included vitrectomy, the separation of the posterior hyaloid, the internal limiting membrane peeling, and gas tamponade. No laser was performed. The vision improved to 20/20, and optical coherence tomography demonstrated that the inner retinal layer separation was resolved except for the ganglion cell layer connected to the optic nerve pit, and subretinal fluid was increased 1 month after surgery. Eventually, the retinal layer separation and the subretinal fluid were resolved completely.

Vitrectomy with internal limiting membrane peeling and gas tamponade without any additional laser photocoagulation seems to be sufficient for the treatment. Our observations suggest that the fluid can move directly from the optic pit into multiple layers, and fluid emanating from the optic nerve pit still extended even after surgery.