PMC2788588_01
Color fundus photograph of the right eye, depicting an optic nerve pit with peripapillary atrophy. Mild pigmentary changes are present in the macula. Arrow heads point to the margins of the pit.
opth-3-625f1.jpg
PMC2788588_01_opth-3-625f1.jpg
f1-opth-3-625
Fundus examination revealed the presence of a temporal optic nerve pit OD (Figure 1), with pigmentary changes and fine drusen in the macula OU.
A) Combined infrared imaging and SD-OCT (spectralis; Heidelberg engineering, Germany) demonstrate excavation of the optic nerve with an adjacent area of outer retinal atrophy. Arrow heads pointing to the excavation seen on spectralis OCT. B) spectralis OCT scan demonstrates loss of the photoreceptor outer segments with preservation of the underlying retinal pigment epithelium. Arrow indicating the point where inner segment-outer segment junction of the photoreceptor becomes discontinues indicating atrophy. RPE is seen as a dark continuous band.. Abbreviations: OCT, optical coherence tomography; RPE, retinal pigment epithelium.
opth-3-625f2.jpg
PMC2788588_01_opth-3-625f2.jpg
f2-opth-3-625
SD-OCT (Spectralis; Heidelberg Engineering, Heidelberg, Germany) sections through the pit demonstrate excavation in the optic nerve (Figure 2A). In addition, an area of outer retinal atrophy is noted adjacent to the optic nerve pit with preservation at the fovea (Figure 2B).
A) Retinal thickness mapping demonstrates thinning of the retina in the paillomacular bundle, extending inferior temporally. B) Fundus autoflourescence shows hyperfluorescence in the area of retinal thinning. C) Microperimetry (MP-1) demonstrates loss of threshold corresponding to the area of thinning. The blue dots are a fixation map of the patient while doing the test. Color codes indicate visual sensitivity in decibels.
opth-3-625f3.jpg
PMC2788588_01_opth-3-625f3.jpg
f3-opth-3-625
Retinal thickness mapping using automated analysis highlighted an area of retinal thinning that extended inferior temporally from the pit (Figure 3A). Hyperflourescence was present on FAF (Spectralis; Heidelberg Engineering) imaging in the area of retinal thinning (Figure 3B). MP-1 (Nidek, Gamagori, Japan) revealed significant reduction in threshold in this region, with preserved function at the fovea and sparing of retina superiorly (Figure 3C).