Optic pit maculopathy: incidence and clinical course

Purpose: The aim of this case series was to investigate the clinical course of patients with optic pit maculopathy. Methods: The medical records of all patients diagnosed with optic pit maculopathy in the past 10 years were reviewed. Optic pit maculopathy was diagnosed when localized intraretinal or/and subretinal fluid spread from the optic nerve to the macula. Outcome measures included changes in best corrected visual acuity (BCVA), central retinal thickness (RT) as well as nasal parafoveal and perifoveal RT. Results: An optic disc pit was detected in 18 patients (9 female, 9 male, mean age: 33 +/- 23 years). Retinal fluid accumulation was present in 6 (33.3%) of the patients (1 intraretinal, 1 subretinal, 4 intraretinal and subretinal). Pars plana vitrectomy with removal of peripapillary vitreous traction and peeling of the internal limiting membrane (ILM) was indicated in 5 patients and was performed in 4 patients. One patient underwent nanopulse laser treatment instead. The patients with optic pit maculopathy were 47 +/- 16 years old. In this group of patients, mean BCVA (decimal) improved from 0.3 +/- 0.2 before treatment to 0.5 +/- 0.2 3 months after treatment (p=0.03). Visual acuity improved in all patients with optic disc pit maculopathy after pars plana vitrectomy. The mean central RT decreased from 796 +/- 214 before treatment to 324 +/- 57 3 months after treatment (p=0.005). The mean nasal parafoveal RT decreased from 683 +/- 87 before treatment to 372 +/- 41 (p=0.0003) and the mean nasal perifoveal RT decreased from 547 +/- 89 before treatment to 360 +/- 48 (p=0.007). A completely dry macula was achieved in 4 eyes after a mean follow-up of 3 months. At long-term follow-up (2.5 +/- 1.2 years), no recurrence occurred in the vitrectomized eyes. Conclusion: This case series showed that more than one third of the patients had optic pit maculopathy presumably caused by disruption of the Kuhnt intermediate tissue. Interventional treatment was indicated in all cases, of which 4 were surgically treated and resulted in significant improvement of function and anatomical retinal structures.