Optical coherence tomography characteristics in eyes with optic disc pit with or without maculopathy

• Main Author: Dhileesh P Chandrasekharan
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2018-01-01
• Series: Kerala Journal of Ophthalmology
• Subjects: Maculopathy; optic disc pit; retinoschisis
• Online Access: http://www.kjophthal.com/article.asp?issn=0976-6677;year=2018;volume=30;issue=1;spage=28;epage=31;aulast=Chandrasekharan

Purpose: The purpose of this study is to study the optical coherence tomography (OCT) characteristics of optic disc pit with or without maculopathy and to validate the mechanism of fluid passage from the optic disc pit to the macula. Materials and Methods: The medical records of 28 patients (28 eyes) with the diagnosis of optic disc pit were reviewed. Clinical features that were studied included the duration of visual impairment, initial visual acuity, and associated fundus features. OCT characteristics including the presence or absence of macular changes, communication with pit, layer (s) of retina involved in schisis, and presence of serous macular detachment (SMD) were noted. Results: The mean age of the patients was 35.32 years. The mean best-corrected visual acuity (BCVA) at presentation was 0.814 ± 0.684 (log of the minimum angle of resolution). Ten of the 28 eyes (35.7) had combined outer and inner layer schisis with no SMD, whereas 6 eyes (21.4%) had combined outer and inner layer schisis with SMD. Four eyes had outer layer schisis only and two eyes presented with outer layer schisis and subretinal fluid. One eye had inner layer schisis alone and one eye had atrophic macula with no schitic changes. Four eyes had no evidence of any maculopathy on OCT. Communication between the schitic cavity to the gap in the lamina cribrosa at the level of the optic pit could be demonstrated on enhanced depth imaging (EDI-OCT) in 14 eyes. The OCT characteristics between the eyes with BCVA >6/12 (Group A) and <6/12 (Group B) were compared. Outer layer retinoschisis was seen in six eyes in Group A compared to 14 eyes in Group B. This was statistically significant (P = 0.044, Fisher's exact test). Mean central macular thickness was 414.5 ± 136.84 μm in Group A and 746.37 ± 433.9 μm in Group B. The difference was statistically significant (P = 0.023, Mann–Whitney U-test). Conclusion: This study validates the hypothesis that cerebrospinal fluid could be the source of fluid in optic disc pit maculopathy as a communication could be demonstrated between the schitic cavity to gap in the lamina cribrosa could be demonstrated on EDI.