Optic Nerve Pit
Optic nerve pit (optic hole) represents herniation of dysplastic retina into a collagen-lined pocket extending posteriorly, often into the subarachnoid space, through a defect in the lamina cribrosa. It is typically unilateral. There is an association with serous macular detachments in the second and third decades of life.
The typical appearance is a round or oval, gray, white, or yellowish depression in the inferotemporal quadrant or central portion of the disc, often covered with a gray veil of tissue and emerging cilioretinal vessels (Fig 26-6).
Figure 26-5 Optic nerve coloboma, right eye.
Figure 26-6 Left optic nerve with a temporal optic nerve pit (arrow) and a mild inferonasal disc coloboma. Cilioretinal vessels can be seen emanating from the optic nerve pit.
(Courtesy of Paul Phillips, MD.)
Some have considered this entity to be a variant of coloboma, but it is distinct and there is no association with iris or chorioretinal coloboma.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.