Atlas of Ophthalmology

Pit of Optic Nerve Head with Focal Loss of Retinal Nerve Layer (Colour Photography Posterior Pole, OCT Triton, Visual Field)

视神经 -> Congenital Anomalies
Patient: 34 years of age, female, BCVA 1.0 at OD , 1.0 at OS, IOP 17/15 mmHg. General Medical History: empty. Ocular Medical History: unclear visual field defect at OD. Main Complaint: vision decline at OD. Purpose: to present pseudo-glaucomatous visual field defect in pit of optic nerve head. Methods: colour photography posterior pole, OCT Triton, visual field. Findings: Colour Photography Posterior Pole: myopic configuration, herniation of retinal tissue with focal rim excavation at 7h. Visual field: visual field defect temporal superior. OCT Triton, macula: regular macula, deep rim excavation at 8h. OCT Triton, retinal nerve layer: focal thinning from 6-9h Discussion: In general pits of the optic nerve head (OPD) are oval cavities or depressions in the optic disc. Itis a herniation of dysplastic retinal tissue into a collagen rich excavation extending into the subarachnoid space through a defect in the lamina cribrosa. Pits of the optic nerve can appear as a localized pit-like invagination in the optic disc. They can be congenital or acquired. ODPs can remain clinically asymptomatic in many cases. In about 50% patients with ODPs develop optic disc pit related maculopathy with retinoschisis, atrophy of inner retinal layers, serous macular detachment and significant loss of vision. 1-2 Literature: 1. Wiethe T. Ein Fall von angeborener Deformität der Sehnervenpapille. Arch Augenheilkd. 1882;11:14–19. 2. Georgalas I, Ladas I, Georgopoulos G, Petrou P. Optic disc pit: a review. Graefe's Arch Clin Exp Ophthalmol Albrecht Graefes Archiv Klin Exp Ophthalmol. 2011;249:1113–1122.

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