Optic pits are congenital anomalies of the optic disc of unknown pathophysiology. About 45% are associated with either macular retinoschisis or serous retinal detachments. Peripapillary vitreous traction has been proposed to be involved and vitrectomy is reported as an effective therapy, with induction of posterior vitreous detachment even without gas tamponade or laser photocoagulation.

Case Report:

The authors report the case of a 32-year-old female patient presenting with a painless visual acuity decrease in the right-eye, with a BCVA of 20/125. OCT examination and angiography confirmed the diagnosis of an optic pit associated with a large serous macula-off retinal detachment extending beyond the vascular arcades. The patient also had a visual field examination, revealing widespread defects in the central 30 degrees of vision. A 23 G vitrectomy was the procedure of choice, with complete posterior vitreous detachment and ILM peeling, laser photocoagulation of the temporal border of the optic disk and gas tamponade. Follow-up over the next 2 years revealed a gradual but complete resolution of the subretinal fluid accumulation, a BCVA of 20/22 along with an almost fully recovered visual field. By 2014, re-examination confirmed the stability of the optic pit and laser-treated border, with the patient having almost no intraretinal fluid and a BCVA of 20/22 almost 5 years post-surgery.


Vitrectomy is an effective therapy for serous macular detachments associated with an optic pit. Although fluid reabsorption can be slow, visual acuity can be recovered with an excellent and durable outcome.

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Main references:

  • Hirakata A, Inoue M, et al. Vitrectomy without Laser Treatment or Gas Tamponade for Macular Detachment Associated with an Optic Disc Pitâ. Ophthalmology, 2012-04-01, Volume 119, Issue 4, Pages 810-818
  • Bottoni F, Secondi R, et al. Maculopathy Resolution after Surgery for an Optic Disc Pit. Ophthalmology, 2013-04-01, Volume 120, Issue 4, Pages 877-878