Progressive Retinal Nerve Fiber Layer Atrophy Associated With Enlarging Peripapillary Pit

To report a case in which progressive retinal nerve fiber layer (RNFL) atrophy was observed along with enlargement of the peripapillary pit.

A 34-year-old male was diagnosed with primary open-angle glaucoma and followed up for 4 years with regular ophthalmic examinations. Both eyes were myopic (-10 D, OD and -10.5 D, OS), and untreated intraocular pressures were 18 mm Hg (OD) and 16 mm Hg (OS).

A subtle depression of the superotemporal peripapillary area was deepened and emerged as a peripapillary pit during the follow-up period. With the enlargement of the peripapillary pit, a RNFL defect at the location of pit widened and thinned continuously. The enlargement of the pit was documented by the spectral-domain optical coherence tomography posterior pole scanning.

Progressive RNFL atrophy was observed with enlargement of the peripapillary pit. The finding suggests that tensile stress derived from the scleral stretching may have significant influence on the integrity of the RNFL.