Optic nerve disc maculopathy: epidemiology, etiology, pathophysiology, diagnosis, conservative and surgical treatment options (a literature review)

Ieva Kunickaitė1

1Vilnius University, Faculty of Medicine, Vilnius, Lithuania


Introduction. The optic nerve disc (OND) pit is a rare, usually unilateral asymptomatic congenital pathology of the optic nerve disc. 50% of OND pit  cases  can evolve into macular retinoschisis.  OND pit maculopathy is diagnosed by ophthalmoscopy and by optical coherence tomography (OCT) examination, which involves the accumulation of subretinal or intraretinal fluid.

Aim. Summarize and present information on the newiest  treatment options of optic disc maculopathy and it‘s outputs.

Methods. The literature review was performed using PubMed, ScienceDirect, and ClinicalKey databases. Scientific articles were analyzed by keywords and their combinations: OND pit, OND pit maculopathy, treatment of OND pit maculopathy. More than 20 publications were examined. Articles used in the literature review are not older than 5 years.

Results. The etiological treatment of the disease is complicated. For the treatment of OND pit maculopathy, a surgical method involving pars plana vitrectomy and filling of the vitreous cavity with gas or laser photocoagulation of the OND pit edge is possible. Conservative treatment with medication (mineralcorticoid antagonist or carbonic anhydrase inhibitor) to avoid surgery is also possible.

Conclusions. Due to the rare prevalence of OND pit maculopathy, comparisons between treatment methods are difficult. However, pars plana vitrectomy remains the primary treatment for this pathology, but conservative treatment with oral spironolactone tablets and / or dorzolamide drops is also effective and non-invasive.


Keywords. OND pit, OND pit maculopathy, OND pit maculopathy treatment.