Henc-Petrinovic L., Kuzmanovic B., Petrinovic-Dorešic J.

Ophthalmology Department, General Hospital "Sveti Duh", Sveti Duh 64, 10000 Zagreb, Croatia

Purpose: Echography and fluorescein angiography were used to evaluate decompensation of congenital colobomatous anomaly of the optic nerve head: "pit of the disc".
Methods: 11 patients in 13 years (6 women and 5 men), age 18-32 years, were found to have defects in temporal/inferior part of the optic disc with central serous retinal detachment, decreased visual acuity, blurred vision and visual field defects (central and arcuate). Echography revealed more or less visible shallow retinal detachment in the papillo-macular region (exudation). Fluorescein angiography disclosed late filling of the pit with the dye and spreading of the dye under retina, mostly in macular region.
Results: Local cortiocosteriod therapy was applied and symptoms subsided in few weeks. Residual disgrupation of the macular retinal pigment epithelium was found in four patients.
Discussion: Etiopathogenesis of the macular detachment in cases of optic disc pit is not fully understood. New hypothesis of the pit functioning as a conduit between the subretinal and subarachnoidal space seems to be plausible. Another possible component for developing macular detachment might be the vitreal traction. Simultaneous appearance of the posterior hyaloidal detachment and macular reattachment could be the proof for the tractional genesis of macular detachment in cases of optic disc pit. However, results of echography in our study with no signs of posterior hyaloid detachment do not confirm this hypothesis. Better understanding of pathogenesis might result in optimal choice of treatment modality (vitrectomy, gas insuflation, laser coagulation) to prevent visual deterioration.

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