title: Optic disk pit morphology and retinal detachment: optical coherence tomography with intraoperative correlation.
abstract: BACKGROUND
  The pathogenesis of optic nerve head pits and associated retinal detachment, and the most effective surgical intervention when visual loss develops, remains unclear.
  
  
  METHODS
  The morphology of the optic disk in patients with pits was investigated with optical coherence tomography. For those who underwent surgical treatment for pit-associated retinal detachment, the efficacy of treatment by vitrectomy and separation of the posterior hyaloid, with and without additional peeling of peripapillary tissue, was assessed.
  
  
  RESULTS
  On optical coherence tomography imaging, 14 of 18 pits (78%) demonstrated a localized pit-like invagination, whereas 3 (17%) had disks with a generally excavated structure. For 16 of 18 pits (89%), there was evidence of condensed vitreous or glial tissue seen extending from the pit or inside the optic disk. Nine eyes with retinal detachment underwent vitrectomy, posterior hyaloid separation, and endolaser. The retinal detachment completely resolved in 6 of 6 cases where the surgeon additionally peeled the fibrous tissue from the pit and 2 of 3 cases where this was not performed.
  
  
  CONCLUSIONS
  Spectral domain optical coherence tomography demonstrates the varying morphology of optic pit anatomy. Condensed vitreous strands or glial tissue in the optic nerve pit may also contribute to retinal detachment development.
authors.affiliation: Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, New York, USA.
authors.forename: Emily M
authors.initials: EM
authors.lastname: Gregory-Roberts
authors.forename: Carlos
authors.initials: C
authors.lastname: Mateo
authors.forename: Borja
authors.initials: B
authors.lastname: Corcóstegui
authors.forename: William M
authors.initials: WM
authors.lastname: Schiff
authors.forename: Louis K
authors.initials: LK
authors.lastname: Chang
authors.forename: Hugo
authors.initials: H
authors.lastname: Quiroz-Mercado
authors.forename: Sungpyo
authors.initials: S
authors.lastname: Park
authors.forename: Stanley
authors.initials: S
authors.lastname: Chang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005124:Eye Abnormalities / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000002:abnormalities*; D011446:Prospective Studies; D012163:Retinal Detachment / Q000175:diagnosis* / Q000209:etiology; D041441:Retinoschisis / Q000175:diagnosis / Q000209:etiology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D055815:Young Adult