Optic Pits are congenital excavations of optic nerve “head” that may be associated with other optic nerve and peripapillary retina anomalies. They occur in 1/10.000 people, both male and female. More than two thirds of patients develop serous macular detachment with loss of vision. There is controversy about the etiology and nature of maculopathy in these cases.

Clinical Case:

Female patient observed due to painless loss of vision. She had a serous macular detachment with optic pit, with visual acuity <20/200. It was prescribed oral acetazolamide and the patient was advised to rest. After 1 month the patient was observed and the serous detachment had increased, so we decided to perform surgery – vitrectomy with posterior hyaloid detachment, internal limiting membrane peeling, peripapillary laser and C3F8 (14%) gas tamponade. There was resolution of serous detachment and with 2 years of follow up the patient remains clinically stable, with visual acuity 20/22. The optic disc pits are a rare pathology with no consensus therapy. The maculopathy caused by this pathology has a poor prognosis in general. Since the exact pathophysiology is still matter of debate, the therapeutic approach should be individualized.