IMAGING CONGENITAL OPTIC DISC PITS AND ASSOCIATED MACULOPATHY USING OPTICAL COHERENCE TOMOGRAPHY

Objective: To elucidate the anatomy of congenital optic disc pits with and without maculopathy using optical coherence tomography. Setting: All patients were examined, photographed, and scanned at the New York Eye and Ear Infirmary. Patients: Ten eyes of eight consecutive patient s with congenital optic disc pits were studied. Three eyes had associa ted serous macular detachment (group 1), four had evidence of resolved detachment (group 2), and three had no clinical macular pathologic le sion; (group 3). Methods: Optical coherence tomography, a new, noninva sive, noncontact, imaging technology capable of producing cross-sectio nal images of the retina in vivo with high resolution (<17 mu m) was u sed to obtain multiple cross-sectional images of the pit, peripapillar y retina, and macula. Ophthalmologic examination and standard fundus p hotography were performed on all eyes. Fluorescein angiography was per formed in eyes that had associated macular detachment. Results: Commun ication between a schisis cavity or subretinal space and the optic ner ve 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 gro ups 1 and 2 and in one patient in group 3. A direct communication betw een the subretinal space and vitreous cavity could not be identified i n any eye. Conclusions: Schisis formation plays an integral role in th e development of serous retinal detachment in the presence of congenit al optic disc pits. Our findings are consistent with the theory that t he optic disc pit acts as a conduit for fluid flow between the schisis cavity or subretinal space and the subarachnoid space.