Optic Disc Pit with Peripapillary Retinoschisis Presenting as a Localized Retinal Nerve Fiber Layer Defect

Abstract

A 59-year-old woman was referred to our clinic for a glaucoma evaluation. The visual acuity and intraocular pressure were normal in both eyes. However, red-free fundus photography in the left eye showed a superotemporal wedge-shaped retinal nerve fiber layer defect, and visual field testing showed a corresponding partial arcuate scotoma. In an optical coherence tomography examination, the macula was flat, but an arcuate-shaped peripapillary retinoschisis was found. Further, the retinoschisis seemed to be connected with a superotemporal optic pit shown in a disc photograph. After 3 months of a topical prostaglandin analogue medication, the intraocular pressure in the retinoschisis eye was lowered from 14 to 10 mmHg and the peripapillary retinoschisis was almost resolved. We report a rare case of an optic disc pit with peripapillary retinoschisis presenting as a localized retinal nerve fiber layer defect.

Effect of peripapillary retinoschisis on retinal nerve fibre layer thickness measurement in glaucomatous eyes

“…However, vitreopapillary traction was not found in the cross-sectional OCT images of the RNFL in the present cases. Peripapillary retinoschisis may be found in combination with optic pit16 or foveal retinoschisis 17–20. Song et al 16 reported a case with optic disc pit with peripapillary retinoschisis presenting as a localised RNFL defect.…”

“…Peripapillary retinoschisis may be found in combination with optic pit16 or foveal retinoschisis 17–20. Song et al 16 reported a case with optic disc pit with peripapillary retinoschisis presenting as a localised RNFL defect. Further, Meirelles et al 17 reported a case with deep colobomatous excavation of the optic disc and secondary retinoschisis extending from the temporal side of the optic disc, and they speculated that the connection between the optic disc pit and the RNFL is a cause of retinoschisis.…”

Inverted autologous internal limiting membrane for management of optic disc pit with macular detachment

“…Histologically, optic disc pits are defects in the lamina cribrosa. [ 2 3 ] Visual acuity gets affected when the pit is complicated by serous macular retinal detachment.…”

“…An optic disc pit represents a defect in the lamina cribrosa. [ 2 3 ] Hence, the theoretically ideal procedure for reattaching the macula associated with an optic disc pit would be a procedure that prevents the flow of fluid across/through the pit by creating an additional barrier. We present a novel surgical technique where the patient's autologous internal limiting membrane (ILM) is transplanted onto the optic disc pit to create this barrier.…”

The Progression of Peripapillary Retinoschisis May Indicate the Progression of Glaucoma

“…We also identified lamina cribrosa (LC) defects, 9 optic pits, 10 vitreous traction, 5 and signs of the intra-disc prelaminar splitting in PPRS 4 , 7 , 9 based on the reported association with PPRS. We used 24 radial-line B-scans of enhanced-depth imaging OCT, each obtained at an angle of 7.5° and centered on the optic disc, following previously described methods.…”