LAUSR

Temporally located optic nerve head pits pose a risk for the development of peripapillary retinoschisis and central serous detachment with subsequent vision loss. The prognosis of these cases is usually poor. A variety of presentations described as optic pit foveolar retinoschisis with the absence of a central serous detachment, have been documented to be asymptomatic. In optic pit foveolar retinoschisis, the visual acuities, visual field and fluorescein angiography are all normal. The presence of a conduit located somewhere at the pit that allows movement of fluid into the retina has been identified as a contributing factor in the development of foveolar schisis and central serous detachment associated with an optic nerve pit. A similar mechanism has been speculated to be responsible for peripapillary retinoschisis and central serous detachment in advanced stage glaucoma as well as in pachychoroid spectrum diseases. Lee et al. documented that in acquired pits of the optic nerve and pachychoroid spectrum diseases, the lamina cribrosa defects that were located centrally were associated with an inner layer retinoschisis as opposed to lamina cribrosa disinsertions and lamina cribrosa peripheral defects that gave rise to a schisis of the outer retina. Peripapillary vitreo-retinal traction also contributes to the development of optic pit foveolar retinoschisis. Other factors implicated in the development of optic pit foveolar retinoschisis are retinal inter-cell adhesion deficiencies and structural defects. Although a long-term positive prognosis has been suggested, observation of the long-term stability of optic pit foveolar retinoschisis has not been reported.