Thomas A. Ciulla, MD, MBA, FASRS » Optic Nerve Pit Related Serous Detachment Treated by Vitrectomy with Laser and Gas

A 48 year old woman with a history of optic nerve pit-related serous detachment of the macula previously underwent laser treatment at the temporal aspect of the optic nerve on the right. The serous detachment of the macula persisted. Since it had not responded, she was then told that she might have central serous retinopathy. She was referred to the retina service where she was noted to have visual acuity of 20/200 and persistent submacular fluid, felt to be due to the optic nerve pit. There was no evidence of a central serous retinopathy on angiography. OCT revealed submacular fluid with chronic features, including numerous large cystoid spaces. She underwent vitrectomy, additional laser treatment in the peripapillary region, and infusion of C3F8 gas with face-down positioning. The OCT show the sequential improvement of the macula at 1month, 3 months, 9 months, and 1 year. The visual acuity improved from 20/200 to 20/40 over that time period.