|Year : 2021 | Volume
| Issue : 2 | Page : 206-207
Inferior optic disc pit with bullous retinoschisis – A rare finding
Amber A Bhayana, Shorya V Azad, Priyanka Prasad, Vinod Kumar
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
|Date of Submission||16-May-2020|
|Date of Acceptance||23-Oct-2020|
|Date of Web Publication||01-Apr-2021|
Dr. Shorya V Azad
Dr. Rajendra Prasad Centre, AIIMS, New Delhi - 110 029
Source of Support: None, Conflict of Interest: None
Keywords: Bullous, inferior, maculopathy, optic disc pit, schisis
|How to cite this article:|
Bhayana AA, Azad SV, Prasad P, Kumar V. Inferior optic disc pit with bullous retinoschisis – A rare finding. Indian J Ophthalmol Case Rep 2021;1:206-7
|How to cite this URL:|
Bhayana AA, Azad SV, Prasad P, Kumar V. Inferior optic disc pit with bullous retinoschisis – A rare finding. Indian J Ophthalmol Case Rep [serial online] 2021 [cited 2021 Jun 14];1:206-7. Available from: https://www.ijoreports.in/text.asp?2021/1/2/206/312331
| Case Report|| |
A 45-year-old male presented with painless, gradual, diminution of vision in left eye for the past 7 months. On examination BCVA were 20/20 OD and 20/40 OS. Intraocular pressures and anterior segment was within normal limits OU. OD fundus was normal. OS fundus showed an inferior optic disc pit (ODP) with bullous retinoschisis localized inferior to disc extending to macula [Figure 1] and [Figure 2]. A diagnosis of inferior ODP with retinoschisis was made and patient was conservatively followed in view of good vision. Vision was stable at 6 months follow up.
|Figure 1: (a) Ultra-wide-field pseudocolour image of left eye (Optos) and (b) autoflourescence image showing inferior optic disc pit (arrow) and schisis (outlined by stars)|
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|Figure 2: Swept-source OCT images showing inferior optic disc pit with communicating foveoschisis (horizontal scan- a1, a2) and inferior retinoschisis (vertical scan- b1, b2). (c) Spectral-domain OCT image showing scan centred at the inferior retinoschisis|
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| Discussion|| |
ODP is an oval-shaped depression usually seen at the inferotemporal margin of the disc but can be found elsewhere. Histologically it is a defect in lamina cribrosa allowing dysplastic retina to herniate into the subarachnoid space. ODP by itself is asymptomatic unless complicated by maculopathy which includes intraretinal and subretinal fluid with/without pigmentary changes. Possible origins of fluid described are vitreous, cerebrospinal fluid, leakage from vessels at pit and choroid. Theories for maculopathy include posterior vitreous detachment dependent and independent. Latter involves movement of fluid up and down the pressure gradient from subarachnoid space when downhill movement into retina splits in open. Lincoff et al. described three stages for maculopathy: first, a schisis like separation followed by outer layer macular hole and last involving outer retina detachment. Schisis has been shown to resolve spontaneously. Treatment is aimed mainly towards retinal detachment and described modalities include laser at temporal disc margin, intravitreal gas injection, macular buckling surgery and pars plana vitrectomy. Rarely, optic disc pit has been reported centrally in disc, and more recently in nasal part with subsequent maculopathy. We report another atypical location with localized inferior schisis extending to fovea which has not been described to the best of our knowledge.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
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[Figure 1], [Figure 2]