Neuro-Ophthalmic
Optic Disc Pit
Also known as: optic disc pit, optic pit, congenital optic disc pit, optic nerve pit, optic disc pit maculopathy, pit maculopathy, ODP, acquired optic disc pit
Filed as: Routine
Source-cited from the record's own evidence list. Clinical content programme led by Dr Ankit Mathur, PhD, Grad Cert Ocu Thera, B.S. Optom. How the clinical content is governed
Clinical decision support only
Overview
A congenital optic disc pit is a small excavation in the optic nerve head left by incomplete closure of the embryonic fissure. It is usually in one eye (about 85 percent) and is often found by chance. The pit itself rarely affects central vision. Its importance is the macula: fluid can track from the pit into and under the retina, causing optic disc pit maculopathy in a quarter to three quarters of eyes over a lifetime. A pit without maculopathy is reviewed routinely and the patient is warned about the risk. A pit with maculopathy is referred to an ophthalmologist. An acquired pit is a different finding, seen in glaucoma and in high myopia.
Recognition
Symptoms: what patients report
- Usually none while the macula is dry
- With maculopathy: blurred or distorted central vision in one eye, or a central grey patch
- Occasionally an awareness of a field defect
Signs: what the examination shows
- A small grey, round or oval hypopigmented depression in the disc, about one eighth to one quarter of the disc in size
- Usually at the temporal or inferotemporal edge of the disc; central in 10 to 20 percent
- Unilateral in most patients
- OCT of the disc: a focal excavation in the cup at the level of the lamina cribrosa
- Visual field: may show a paracentral arcuate defect or other defects that resemble glaucoma
- Maculopathy on OCT: retinoschisis, intraretinal fluid in the inner or outer retinal layers or beneath the internal limiting membrane, or a serous macular detachment that reaches the pit
What OptoGuide™ covers for optic disc pit
- Pattern reasoning: what this combination of findings points to, and its differentiators
- Don't-miss risks and escalation triggers
- Management tiers with linked Australian therapeutics
- Referral urgency, specialty, and letter drafting