Inferior optic disc pit with bullous retinoschisis – A rare finding

Amber A Bhayana; Shorya V Azad; Priyanka Prasad; Vinod Kumar

doi:10.4103/ijo.IJO_1530_20

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Year : 2021 | Volume : 1 | 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

Correspondence Address:
Dr. Shorya V Azad
Dr. Rajendra Prasad Centre, AIIMS, New Delhi - 110 029
India

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijo.IJO_1530_20

Abstract

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 Apr 10];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.^[1] 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.^[2] 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.^[3] 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.^[2] Rarely, optic disc pit has been reported centrally in disc^[1],[4] and more recently in nasal part with subsequent maculopathy.^[5] 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

Nil.

Conflicts of interest

There are no conflicts of interest.

References

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2.	Moisseiev E, Moisseiev J, Loewenstein A. Optic disc pit maculopathy: When and how to treat? A review of the pathogenesis and treatment options. Int J Retina Vitreous 2015;1:13.
3.	Lincoff H, Lopez R, Kreissig I, Yannuzzi L, Cox M, Burton T. Retinoschisis associated with optic nerve pits. Arch Ophthalmol 1988;106:61-7.
4.	Theodossiadis GP, Panopoulos M, Kollia AK, Georgopoulos G. Long-term study of patients with congenital pit of the optic nerve and persistent macular detachment. Acta Ophthalmol 1992;70:495-505.
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