Case 14-1. Optic Disc Pitting with Serous Macular Detachment

Clinical Summary

A 63-year-old woman complained of a one day history of blurred vision in her left eye. She reported a prior history of blurring approximately 20 years earlier which took several weeks to resolve. Slit-lamp biomicroscopy (A) showed a large neurosensory detachment in the macula. A deep excavation of the optic nerve head was also observed inferiorly. Visual acuity in this eye was counting fingers.

Optical Coherence Tomography

A vertical scan (13; black line on A) through the optic disc graphically demonstrated pitting of the disc inferiorly The neurosensory retinal detachment was also visualized in a horizontal scan through fixation (C; white line on A), which showed an elevation of 590 jam above the retinal pigment epithelium. Two weeks later, a repeat image (D) through the fovea demonstrated that the fluid accumulation had decreased to 240 yAm beneath the fovea. There was a corresponding improvement in visual acuity to 20/100. Two months later, slit-lamp examination indicated that the detachment had completely resolved. The patient's visual acuity was 20/25. OCT examination (E) demonstrated residual subretinal fluid in the macula, with a height of 80 jum.

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