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Optic disc pit associated with an unusual outer retinal hole and nasal peripheral retinoschisis


Corvi, Federico; Nguyen, Tieu Vy; Juhn, Alexander; Corradetti, Giulia; Al-Sheikh, Mayss; Zweifel, Sandrine A; Sadda, SriniVas R (2020). Optic disc pit associated with an unusual outer retinal hole and nasal peripheral retinoschisis. Retinal Cases & Brief Reports, Publish :Epub ahead of print.

Abstract

PURPOSE
To document a peculiar case of optic disc pit-associated maculopathy (ODP-M) with extensive nasal retinoschisis with lamellar outer retinal hole.

METHODS
Case report.

PATIENT
A 41 year-old woman presented to the eye clinic complaining of new photopsias and enlargement of the blind spot in the left eye. Uncorrected visual acuity was 20/20 in both eyes. Fundus examination of the left eye revealed an anomalous appearing optic nerve with a gray oval depression at the temporal margin of the disk consistent with an ODP.

RESULTS
Optical coherence tomography confirmed the presence of the pit and demonstrated outer plexiform layer schisis superonasal to the fovea as well as extensive inner and outer retinal schisis nasal to the nerve extending to the equator. A large lamellar outer retinal hole was noted nasal to the disk without associated retinal detachment. The vitreous appeared to be attached over the nasal retina.

DISCUSSION
Multimodal imaging revealed an unusual ODP associated retinopathy with dramatically more extensive retinoschisis and a lamellar outer retinal hole nasal to the nerve despite the temporal location of the pit. Although the precise pathophysiologic mechanisms are not fully understood, forces associated with the vitreo-retinal adhesion may have contributed to the distribution of the schisis in this case.

Abstract

PURPOSE
To document a peculiar case of optic disc pit-associated maculopathy (ODP-M) with extensive nasal retinoschisis with lamellar outer retinal hole.

METHODS
Case report.

PATIENT
A 41 year-old woman presented to the eye clinic complaining of new photopsias and enlargement of the blind spot in the left eye. Uncorrected visual acuity was 20/20 in both eyes. Fundus examination of the left eye revealed an anomalous appearing optic nerve with a gray oval depression at the temporal margin of the disk consistent with an ODP.

RESULTS
Optical coherence tomography confirmed the presence of the pit and demonstrated outer plexiform layer schisis superonasal to the fovea as well as extensive inner and outer retinal schisis nasal to the nerve extending to the equator. A large lamellar outer retinal hole was noted nasal to the disk without associated retinal detachment. The vitreous appeared to be attached over the nasal retina.

DISCUSSION
Multimodal imaging revealed an unusual ODP associated retinopathy with dramatically more extensive retinoschisis and a lamellar outer retinal hole nasal to the nerve despite the temporal location of the pit. Although the precise pathophysiologic mechanisms are not fully understood, forces associated with the vitreo-retinal adhesion may have contributed to the distribution of the schisis in this case.

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Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Ophthalmology Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:18 December 2020
Deposited On:08 Feb 2021 08:35
Last Modified:20 Feb 2021 02:14
Publisher:Lippincott Williams & Wilkins
ISSN:1935-1089
OA Status:Green
Publisher DOI:https://doi.org/10.1097/ICB.0000000000001110
PubMed ID:33394960

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