Título

OPTIC DISC MACULOPATHY: A CASE REPORT TO CLARIFY ETIOLOGY

Objetivo

The optic disc pit is a rare congenital anomaly of the optic disc, often associated with maculopathy. Optic disc pit-related maculopathy is described by the accumulation of intraretinal and subretinal fluids in the macular region. Despite advances in multimodal examinations, the etiology of the fluid remains unknown. The present report of an optic disc pit associated with maculopathy illustrates that, through the analysis of pre- and post-treatment results - in this case, retinal photocoagulation - it is possible to obtain a clearer understanding of the origin of the macular fluid in this case, specifically.

Relato do Caso

A 25-year-old female, came initially reported to our hospital due to symptoms of photopsia. She denies any other significant personal or familial ocular history.  Best corrected visual acuity  was 20/20 in both eyes , and slit lamp examination and intraocular pressure were normal. However, retina examination revealed optic colobomas in both eyes. Right optic disc pit and subretinal fluid was diagnosed in left eye. Optical coherence tomography (OCT) identified bilateral colobomatous optic discs and communication between the optic disc pit and a macular serous detachment in left eye. Also a neurological assessment was requested and the MRI showed a thickening in the left optic nerve. Considering the preserved visual acuity, the chosen treatment was laser photocoagulation at the temporal disc margin. One week after photocoagulation, there was almost complete resolution of macular subretinal fluid. Migration of fluid to the superior peripapillary and nasal region, with intraretinal and subretinal fluids were observed along with a communication to the optic disc at those areas.

Conclusão

The origin of macular fluid associated with optic disc pit is a subject of controversy. It's noteworthy that in this patient, no posterior vitreous detachment was observed. The imaging findings in this case support the idea that the origin of the retinal fluid is the subarachnoid space.